Validation of the Clinicians' Cultural Sensitivity Survey for Use in Pediatric Primary Care Settings.
Validation of the Clinicians' Cultural Sensitivity Survey for Use in Pediatric Primary Care Settings.
复制标题
验证临床医生文化敏感性调查在儿科初级保健机构中的使用。
DOI：
10.1007/s10903-023-01469-2
复制
发表时间：
2023
影响因子：
1.9
通讯作者：
Griffith,KevinN
中科院分区：
文献类型：
--
作者：
Loo,Stephanie;Brady,KeriJS;Ragavan,MayaI;Griffith,KevinN
将文化敏感性纳入医疗保健环境对于提供高质量和公平的护理非常重要，特别是对于非白人，非英语或移民的边缘化社区。临床医生文化敏感性调查（CCSS）是一项患者报告的调查，评估临床医生对影响老年拉丁美洲患者护理质量的文化因素的认识;然而，该工具尚未适用于儿科初级保健。我们的目的是检查修改后的CCSS的有效性和可靠性，适用于儿科patients.A方便的抽样方法，以确定符合条件的父母在良好的儿童访问期间，在城市儿科初级保健诊所。父母通过私人场所的电子平板电脑管理CCSS。我们首先进行了探索性因素分析（EFA），以探索CCSS中调查问卷的维度，然后在EFA结果的基础上使用最大似然估计进行了一系列验证性因素分析（CFA）。（N = 212次家长调查）支持评估种族歧视的三因素结构（=0.96），文化肯定的做法（=0.86），健康问题的因果关系（=0.85）。在CFAs中，三因子模型在拟合统计量（包括标度均方根误差近似）方面也优于其他潜在因子结构（0.098），Tucker-Lewis指数（0.936），比较拟合指数（0.950），并根据标准化均方根残差证明了充分拟合我们的研究结果支持在儿科人群中使用的适应CCSS的内部一致性，可靠性和结构效度。
Incorporating cultural sensitivity into healthcare settings is important to deliver high-quality and equitable care, particularly for marginalized communities who are non-White, non-English speaking, or immigrants. The Clinicians’ Cultural Sensitivity Survey (CCSS) was developed as a patient‐reported survey assessing clinicians’ recognition of cultural factors affecting care quality for older Latino patients; however, this instrument has not been adapted for use in pediatric primary care. Our objective was to examine the validity and reliability of a modified CCSS that was adapted for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at an urban pediatric primary care clinic. Parents were administered the CCSS via electronic tablet in a private location. We first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination (=0.96), culturally-affirming practices (=0.86), and causal attribution of health problems (=0.85). In CFAs, the three-factor model also outperformed other potential factor structures in terms of fit statistics including scaled root mean square error approximation (0.098), Tucker-Lewis Index (0.936), Comparative Fit Index (0.950), and demonstrated adequate fit according to the standardized root mean square residual (0.061). Our findings support the internal consistency, reliability, and construct validity of the adapted CCSS for use in a pediatric population.