Development and Psychometric Evaluation of the Transcultural Self-efficacy Scale for Nurses

Purpose: This methodological study was conducted to develop and psychometrically test the Transcultural Self-efficacy scale (TCSE-scale) for nurses. Methods: Initial 41 items for the TCSE-scale were generated based on extensive literature reviews and in-depth interviews with 18 nurses who had experience in caring for foreign patients. Cultural Competence and Confidence model was used as a conceptual framework. Content validity was evaluated by an expert panel. Psychometric testing was performed with a convenience sample of 242 nurses recruited from four general hospitals in the Seoul metropolitan area and Gyeonggi-do province of South Korea. To evaluate the reliability of TCSE-scale, a test-retest reliability and an internal consistency reliability were analyzed. Construct validity, concurrent validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. Results: The 25-item TCSE-scale was found to have three subscales-Cognitive, Practical, and Affective domain-explaining 91.5% of the total variance. TCSE-scale also demonstrated a concurrent validity with the Cultural Competence Scale. Criterion-related validity was supported by known-group comparison. Reliability analysis showed an acceptable-to-high Cronbach's alpha-.88 in total, and sub scales ranged from .76 to .87. The ICC was .90, indicating that the TCSE-scale has internal consistency and stability of reliability. Conclusion: This preliminary evaluation of the psychometric scale properties demonstrated an acceptable validity and reliability. The TCSE-scale is able to contribute to building up empirical and evidence based on data collection regarding the transcultural self-efficacy of clinical nurses. We suggest further testing of the applicability of TCSE-scale in different settings and community contexts.