Construct validation of the Nurse Cultural Competence Scale: a hierarchy of abilities

J Clin Nurs. 2012 Jun;21(11-12):1678-84. doi: 10.1111/j.1365-2702.2011.03933.x. Epub 2012 Jan 13.


Aim: The aim of this study was to describe the development of a Nurse Cultural Competence Scale using Mokken scaling.

Background: The psychometrics of the present cultural competence assessment tools has been questioned. The levels of competence measured by existing tools are not capable of indicating individual differences.

Design: This study employed a cross-sectional design. A convenience sample of 172 on-the-job nursing students in a college of technology in Taiwan was recruited.

Methods: Based on previous literature, the Nurse Cultural Competence Scale comprising 41 items was developed to measure the concept of cultural awareness, cultural knowledge, cultural sensitivity and cultural skill. Mokken scaling analysis was conducted to investigate the unidimensionality and hierarchical nature of the scale.

Results: From the 41 items entered into the Mokken scaling procedure, 20 form a strong Mokken scale. The 20 items form a reliable and statistically significant scale which is negatively skewed. The ordering of the items from lowest to highest difficulty shows a hierarchy.

Relevance to clinical practice: Nursing managers and educators may use this scale to assess the levels of cultural competence of their members or students and then provide the education according to individual needs.

Publication types

  • Validation Study

MeSH terms

  • Cross-Sectional Studies
  • Cultural Competency*
  • Nurses*
  • Taiwan