Henrietta Bernal

Influences on the cultural self-efficacy of community health nurses.

This paper presents the results of factor and regression analyses conducted on the Cultural Self-Efficacy Scale to determine the underlying conceptual structure, and relationship to demographic variables. The Cultural Self-Efficacy Scale was first used with a sample of 190 community health nurses in Connecticut. It has an estimated total scale internal consistency of .97. In 1988, data were collected to examine cross-cultural self-efficacy of nurses working in a variety of settings, including health departments. The principal factor analysis revealed a four factor structure that is conceptually meaningful. Taken together, the four factors accounted for 90% of the total scale variance. Regression analyses showed significant relationships between perceptions of efficacy and demographic variables of race, education, and experience.

Acculturation level and postpartum depression in Hispanic mothers.

Purpose:Perinatal health outcomes for Hispanic women are associated with acculturation. The purpose of this study was to explore the relationship between acculturation levels and postpartum depressive symptomatology and diagnosed postpartum depression among Hispanic subgroups. Study Design and Methods:The Postpartum Depression Screening Scale and the Short Acculturation Scale were used in the two phases of data collection. Phase 1 and 2 samples consisted of 377 and 150 Hispanic mothers, respectively. Puerto Rican mothers showed higher levels of acculturation than Mexican and other Hispanic women. A DSM-IV diagnostic interview (SCID) was used to establish a diagnosis of depression. Hierarchical regression analyses were used to study the unique relationships between ethnicity, depressive symptomatology, diagnosed depression, and acculturation. Results:There was no consistent relationship between acculturation and postpartum depression. Significant predictors of elevated postpartum depressive symptoms in Hispanic mothers were Puerto Rican ethnicity and cesarean delivery. Single martial status was a significant risk factor for postpartum depression. A limitation of the study was use of language as the sole criterion measure for acculturation. Acculturation is a complex construct with problematic measurement that needs greater refinement to facilitate research in which it is used as a variable. Clinical Implications:Hispanic mothers are a heterogeneous group and should not be treated as a homogeneous group. Subgroups of Hispanic mothers may not have the same level of acculturation or the same level of postpartum depressive symptomatology.

Acculturation and Stress in a Low-Income Puerto Rican Community

In this study, the acculturative stress experienced by Puerto Rican migrants to the urban U.S. is examined. Acculturative stress is defined as length of residence in a novel cultural environment while lacking psychosocial resources to support adaptation to that environment. In a sample of 67 patients seen in a public health nursing agency, it was found that acculturative stress was associated with poorer health status, more behavioral problems, and higher levels of ethnomedical belief. The implications of these results for research on stress and adaptation are discussed.

The level of cultural self-efficacy among a sample of Spanish nurses in southeastern Spain.

A collaborative study between faculty from the United States and Spain was undertaken to investigate levels of cultural self-efficacy among a sample of Spanish nursing students and nurses. Bandura’s self-efficacy theory provided the conceptual framework for this descriptive study. The Spanish version of the Cultural Self-Efficacy Scale (CSES-S) was translated from the original developed by Bernal and Froman using the back-translation technique recommended by Brislin. The CSES-S was administered to 113 Spanish nurses and students. Alpha coefficient results for the CSES-S ranged from .90 to .95. Low to neutral levels of confidence in caring for four ethnic groups were found. Regression analyses showed significant relationships between cultural exposure and cultural self-efficacy for the practicing nurses. Results will assist this collaborative transcultural nursing research effort between the United States and Spain to develop and implement programs and experiences to increase cultural self-efficacy among Spanish nurses and improve care provided to Spain’s diverse population.