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PubMed1998

Intraethnic comparison of eating attitudes in native Koreans and Korean Americans using a Korean translation of the eating attitudes test.

Although Asian samples have been studied using the Eating Attitudes Test (EAT-26), the literature lacks data on Korean samples. Furthermore, although cross-cultural studies of eating disorders have been done, intraethnic studies are lacking. This study concerns an intraethnic Korean comparison of eating attitudes. The EAT-26 was translated into Korean and validated by back-translation and by a preliminary study on 32 bilingual (Korean and English-speaking) Korean women. The validated Korean translation was completed by a sample of 195 native South Koreans (NKs) and the original version by a sample of 39 Korean Americans (KAs). EAT-26 scores seemed to indicate that the NKs had more disordered eating attitudes. Furthermore, the KAs appear to be a low-risk sample for eating disorders. Implications for further research are discussed.

Adolescent↗
PubMedDate not supplied

Constructing and testing a self-help intervention program for high blood pressure control in Korean American seniors--a pilot study.

Although significant progress has been made in the reduction of overall cardiovascular risk factors in the United States during the last decade, controlling high blood pressure (HBP) remains a difficult task for many individuals. In particular, socially disadvantaged groups, such as new immigrants, and ethnic minority groups, such as Korean Americans, continue to struggle with this chronic disease and suffer unnecessary complications. We conducted a quasi-experimental study to test the efficacy of a self-help intervention program for HBP control in first-generation Korean American seniors with HBP. The intervention consisted of 3 concurrently administered components: (1) structured behavioral education on HBP management, (2) home blood pressure (BP) monitoring, and (3) monthly support groups facilitated by a bilingual nurse. Of the 49 Korean American seniors (> or =60 years old) who agreed to participate, 31 received the intervention and completed the follow-up interviews at 6 months. Final analysis of BP outcomes using repeated measures and postintervention data suggested that the self-help intervention was effective in significantly improving the proportion of individuals who achieved BP control (<140/90 mm Hg) and in lowering both systolic and diastolic BP in the sample. Specifically, the BP control rate, which was 29% at baseline, increased at 6 months to 69%. Likewise, the mean systolic and diastolic BP values of 142.7 and 87.1 mm Hg at baseline decreased to 129.3 and 75.3 mm Hg, respectively, after 6 months of follow-up. This improvement of the HBP control rate in the sample highlights the clinical efficacy of the self-help intervention for this traditionally underserved immigrant group.

Aged↗
PubMed1998

Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients.

OBJECTIVES: Many patients have limited English proficiency and require an interpreter. The authors evaluated the effect of current interpreting practices on Spanish-speaking patients' satisfaction with the patient-provider relationship. METHODS: A cross-sectional survey was conducted of 457 patients seen in a public hospital emergency department. Measures were satisfaction with the provider's friendliness, respectfulness, concern, ability to make the patient comfortable, and time spent for the exam. RESULTS: A total of 237 patients communicated adequately with their provider without the use of an interpreter (group 1), 120 patients communicated through an interpreter (88% of whom were ad hoc interpreters; group 2), and 100 patients communicated directly with the provider but said an interpreter should have been called (group 3). Compared with patients in group 1, patients who communicated through an interpreter (group 2) rated their provider as less friendly, less respectful, less concerned for the patient as a person, and less likely to make the patient comfortable. Patients who said an interpreter should have been called (group 3) had the lowest satisfaction ratings; compared with group 2, they were less satisfied with their provider's friendliness, concern for the patient as a person, efforts to make the patient comfortable, and amount of time spent. CONCLUSIONS: Patients who communicated through an interpreter or who did not have an interpreter when they thought one was necessary were less satisfied with the patient-provider relationship. Further efforts are needed to ensure interpreter availability and proper interpretation technique.

Adult↗
PubMed2002

Does being bilingual in English and Chinese influence responses to Quality-of-Life scales?

BACKGROUND: It is not known if the inclusion of bilinguals affects the results of research using Quality-of-Life (QoL) scales. OBJECTIVE: To determine the influence of bilingualism on responses to a QoL scale. RESEARCH DESIGN: In this cross sectional study, a population-based, disproportionately stratified random sample of monolingual and bilingual ethnic Chinese completed the Short-Form 36 Health Survey (SF-36) in English or Chinese (representing an alphabet and pictogram based language respectively). Cumulative logit regression models were used to assess the influence of bilingualism on SF-36 scores, while adjusting for the influence of questionnaire language and known determinants of QoL. RESULTS: English or Chinese SF-36 versions were completed by 1331 and 1380 subjects respectively (49% female, aged 21-65 years, 1366 bilingual, 501 English monolingual, 844 Chinese monolingual), with response rates exceeding 85%. Fifty percent of subjects were bilingual. Bilinguals differed from monolinguals in known determinants of QoL, being younger, better educated, and having fewer chronic medical conditions, and had SF-36 scores up to 8 points higher than monolinguals. After adjusting for these differences, bilingualism did not influence scores for any of eight SF-36 scales, whereas questionnaire language influenced scores for four scales. Use of the English SF-36 was associated with higher scores for General Health, Vitality, Role Emotional and Mental Health Scales (odds ratios 1.35-1.41), though the magnitude of these odds ratios suggests this association may not be clinically important. CONCLUSION: Bilingualism did not influence responses to a QoL scale in this large, population-based study of subjects fluent in an alphabet and/or pictogram based language.

Adult↗
PubMedDate not supplied

An adaptation of Brislin's translation model for cross-cultural research.

BACKGROUND: The number of nurse scientists pursuing cross-cultural research using quantitative designs is increasing. Preparation of instruments that are conceptually and functionally appropriate in the language of the participants is a complex process that needs examination. OBJECTIVES: Brislin's classic model for translation and validation of instruments for cross-cultural research is critiqued. Adaptations and extensions of that model are recommended. METHODS: Brislin's model guided tool preparation in a cross-cultural investigation. The process is described and lessons learned are outlined and discussed. CONCLUSIONS: Steps toward a more efficient and valid approach to the preparation of instruments are suggested.

Asian↗
PubMedDate not supplied

Acculturation, resilience, and depression in midlife women from the former Soviet Union.

BACKGROUND: A growing body of literature has demonstrated that demographic factors and acculturative stress contribute to depression in recent immigrants from many countries. Few studies examine potentially protective personality factors, such as resilience, for dealing with the challenges related to the early postmigration transition period. OBJECTIVES: The purpose of this analysis is to examine relationships among demographic characteristics, acculturation, psychological resilience, and symptoms of depression in midlife women from the former Soviet Union who recently immigrated to the United States. METHOD: Data for this analysis are from a larger cross-sectional study that explored the impact of immigration during midlife on women's health. The volunteer sample included 200 women from the former Soviet Union, 45-65 years old, who had lived in the U.S. fewer than 6 years. This analysis involves measures of acculturation, demands of immigration, resilience, and depressed mood. RESULTS: Findings include very high scores on the depression scale compared to U.S. norms. Older women, and those reporting greater demands of immigration, had higher scores on the depression scale. However, lower depression scores were found for women reporting greater English usage and resilience. DISCUSSION: The results corroborate previous studies that suggest high levels of depression in immigrant women, but additional validation is suggested to differentiate symptoms of depressed mood from clinical depression in this culture. Findings also suggest that interventions that encourage use of English language and enhance resilience may help decrease symptoms of depression in midlife women who are recent immigrants from the former Soviet Union.

Acculturation↗
PubMedDate not supplied

Strengths and vulnerabilities of women of Mexican descent in relation to depressive symptoms.

BACKGROUND: The majority of research related to depression among women of Mexican descent has focused on risk factors and resources without considering intrinsic strength factors that may have a protective function. An additional focus on mastery, resilience, and life satisfaction will expand the context for understanding the mental health of women of Mexican descent. OBJECTIVES: This study describes the level of depressive symptoms experienced by low-income women of Mexican descent living in an urban community in northern California and compares the level of symptoms by exposure to the United States (US) during childhood. Rather than focus only on negative demographic characteristics (such as lower socioeconomic status) associated with high levels of depressive symptoms, this study also focused on strengths and resources that may minimize or modify depressive symptoms. METHODS: Questionnaires were completed by a cross-sectional convenience sample of 315 women of Mexican descent, aged 21-40 years. Data were analyzed using descriptive statistics and multiple regression. RESULTS: Women who spent all of their childhood years in Mexico before coming to the US had a lower level of depressive symptoms (p <.05) and more satisfaction with life than women who were exposed to the US in childhood (p =.001). While income, adequacy of financial resources, partner status, alcohol use, and childhood exposure to the US accounted for 13% of the variance in depressive symptoms, intrinsic strength factors such as mastery, life satisfaction, and resilience accounted for an additional 31% of the variance (p <.001). DISCUSSION: Although intrinsic strength factors have rarely been included in research related to depression in women of Mexican descent, they were more directly related to lack of depressive symptoms than traditional demographic risk factors.

Acculturation↗
PubMedDate not supplied

United States Spanish short-form-36 health survey: scaling assumptions and reliability in elderly community-dwelling Mexican Americans.

BACKGROUND: Measuring health status is challenging in Mexican Americans and other diverse groups, because most health measurement instruments were developed and tested in English. Thus, it is difficult to determine whether measured health disparities are the result of actual differences or due to measurement error resulting from translation or conceptual differences. OBJECTIVES: The purpose of this study was to test the metric equivalence of the United States (US) Spanish Short-Form-36 Health Survey (SF-36) in a group of elderly Mexican Americans. In addition, the SF-36 scores of elderly Mexican American women in our sample were compared with normed scores for the SF-36 scales in the general population of elderly US women. METHOD: Health status was measured by the US Spanish SF-36 in telephone surveys conducted entirely in Spanish. The sample (N = 65) was elderly (mean age 75.3) and primarily female (78%). Most had less than 7 years of education and an annual income below $10,000. RESULTS: Missing data were negligible, and did not indicate difficulty with particular items. The item response values were well distributed and item response means were generally similar within a scale. Most item correlations were higher with the item's hypothesized scale than with other scales, though some items in the Mental Health, Vitality, and Social Functioning scales were highly correlated with other scales. Internal consistency reliability (Cronbach alpha) was.80 or above on all scales except Social Functioning (.69). SF-36 scale scores were lower in elderly Mexican American women than in elderly women in the general US population. DISCUSSION: The US Spanish SF-36 was a generally satisfactory measure of health status in a sample of elderly Mexican Americans with little formal education. The performance of some items in the Mental Health, Vitality, and Social Functioning scales warrants further research.

Acculturation↗
PubMedDate not supplied

Challenges in language, culture, and modality: translating English measures into American sign language.

BACKGROUND: Few health-related questionnaires have been translated into American Sign Language (ASL), precluding Deaf adults from full participation in health-related research. OBJECTIVES: To translate self-report measures (written English) into sign language and to evaluate the equivalence of the ASL versions to the original English versions of the measures. METHODS: A descriptive-comparative design with a derived etic (outsider) perspective was used to evaluate equivalency between the English version of the Self-Rated Abilities for Health Practices (SRAHP) and an ASL version. Both versions were administered to 24 bilingual (English and ASL) adults. Analysis included correlation between total scores and comparison of internal consistency of both versions; psychometric properties of the signed SRAHP were computed for 105 Deaf adults who participated in a study of the Deaf Heart Health Intervention (DHHI). RESULTS: The correlation between total scores on ASL and English versions was .92, item-to-total correlations ranged from .08 to .80 on the English version and from .33 to .80 on the ASL version. Cronbach's alpha was .91 for the English version and .90 for the ASL version. Mean scores on the ASL version were significantly lower for the all-Deaf DHHI sample (n = 105) than for the bilingual subjects (n = 24) although internal consistency remained high (Cronbach's alpha of .93 and item-to-total correlation of .38-.74) for the new ASL version. DISCUSSION: The use of an adapted translation model resulted in a sound ASL version of a health-related measure. Results support use of the derived etic strategy for translating measures from their original language into new languages. The approach is also appropriate for changing modalities from written form to other modalities, such as the visual-manual modality of ASL.

Adolescent↗
PubMedDate not supplied

Comparison of native versus nonnative English-speaking nurses on critical thinking assessments at entry and exit.

Diversity of language among healthcare employees and nursing students is growing as diversity increases among the general population. Institutions have begun to develop systems to accommodate diversity and to assimilate workers. One barrier to nonnative English-speaking nurse hires may be posed by readiness for the licensure exam and the critical thinking assessments that are now an expected outcome of nursing programs, and act as a gatekeeper to graduation and to employment. To assist in preparing for high-stakes testing, the Assessment Technologies Institute Critical Thinking Assessment was developed in compliance with credentialing bodies' educational outcomes criteria. This pilot study of 209 nursing students was designed to reveal any possible language bias that might act as a barrier to nonnative English speakers. Nursing students were entered as whole classes to the study to control for selection bias. A sample representative of national nursing enrollment was obtained from 21 universities, with 192 (92%) native English-speaking students and 17 (8%) nonnative English speakers participating in the study. All students were given the Assessment Technologies Institute Critical Thinking Assessment at entry and exit to their nursing program. Average scores on entry were 66% for nonnative speakers and 72% for native speakers. At exit, the nonnative speakers had closed the gap in academic outcomes. They had an average score of 72% compared to 73% for native speakers. The study found that the slight differences between the native and nonnative speakers on 2 exit outcome measures-National Council licensure examination (NCLEX-RN) pass rates and Critical Thinking Assessment-were not statistically significant, demonstrating that nonnative English speakers achieved parity with native English-speaking peers on the Critical Thinking Assessment tool, which is often believed to be related to employment readiness.

Bias↗
PubMedDate not supplied

Strategies to promote success on the NCLEX-RN for students with English as a second language.

Faced with an increasingly diverse population and a shortage of nurses, US schools of nursing need to educate nurses from diverse backgrounds. These students may use English as a second language (ESL), leading to challenges that can place them at risk for not passing the NCLEX-RN. The authors present several challenges for ESL students preparing for the NCLEX-RN and successful strategies to coach them. These preparation issues and strategies may also help foreign-educated nurses prepare for the NCLEX-RN.

Acculturation↗
PubMedDate not supplied

An interdisciplinary approach to the needs of non-native-speaking nursing students: conversation circles.

When some students with English as an additional language did not respond appropriately in the clinical setting, faculty speculated that it was due to lack of proficiency in the English language. Faculty were uncertain of instructional interventions to assist these students. The authors describe how faculty members explored the learning needs of their student population with English as an additional language and offer practical suggestions to help other faculty members.

Clinical Competence↗
PubMedDate not supplied

Recommending a minimum English proficiency standard for entry-level nursing.

The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220.

Communication Barriers↗
PubMed2003

Second oral language capabilities in children with cochlear implants.

OBJECTIVE: The development of oral language in children with a cochlear implant is dependent on numerous factors. Although baseline achievements have been established, ceiling attainment levels have yet to be explored. One indicator of a higher capability level is the ability of children with implants to learn to communicate orally using a second language. The purpose of this research was to explore 1) the feasibility of children with cochlear implants developing oral fluency in a second language and 2) the factors that affect the development. STUDY DESIGN: Retrospective study of children fulfilling the criteria. SETTING: University medical center. PATIENTS: Eighteen profoundly hearing-impaired children who were reported to be bilingual. INTERVENTION: Cochlear implantation at age 5 or younger. MAIN OUTCOME MEASURES: The subjects were evaluated using standard speech perception and receptive and expressive language measures. RESULTS: The data revealed the ability of some pediatric cochlear implant recipients to develop competency in a second spoken language in addition to their primary language. Equally as important is the fact that the majority showed age-appropriate receptive and/or expressive language abilities in their primary language commensurate with normal-hearing children. CONCLUSION: High levels of achievement including the learning of a second spoken language are possible after implantation in the pediatric population. Variables include speech perception postimplantation, the linguistic environment, type of intervention, and educational placement.

Child↗