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Evaluating the utility of the FamCHAT ethnocultural nursing assessment tool at a Canadian tertiary care hospital: a pilot study with recommendations for hospital management

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  • Objectives: The multicultural nature of Canadian society and the decline in health of immigrants after relocation to Canada prioritizes a commitment to ensure equity in health care access and outcomes. An important feature shaping health care access and outcomes is the reception of culturally safe and competent care. Partnering with senior management at a tertiary care hospital, this pilot study aimed to investigate whether an identified cultural assessment tool, the Family Cultural Heritage Assessment Tool (FamCHAT), validated for use in a rural primary care setting, was suitable for use in tertiary care. The objectives were to investigate: 1) whether using the FamCHAT enabled the nurses to elicit assessment information from their patients who represent diverse ethnocultural groups, and 2) the nurses’ perspectives on the practical use of this form in their clinical practice. Methods: Nurses purposively selected from the Women’s, Surgery and Medicine units were asked to complete the FamCHAT form with all patients admitted during a three-month period in 2009. Focus group interviews were then held to learn the nurses’ perspectives related to the form’s constructs and its use in their practice. The data from the completed FamCHAT forms were tabulated and analyzed using descriptive statistics to determine the extent of completion and accuracy, and the sample characteristics. The interview data was analyzed using qualitative analytical software (ATLAS.ti Scientific Software Development, GmbH, Germany) and Roper and Shapira’s framework for analysis of ethnographic data. Results: The nurses filled out forty-four FamCHAT forms with patients having a diverse ethnocultural profile. In many forms, several questions were either left blank or answered incorrectly with regard to the guidance notes containing categorical answers for the variables of family size and language. Nine nurses participated in two focus groups (n = 4 and n = 5) and one in an individual interview. Five themes emerged from the qualitative data analysis: feasibility of using the FamCHAT in acute care practice; ethnocultural awareness needs of the participating nurses; perspectives of nurses about patient concerns; potential for enhancement to nursing care assessments; and suggestions for enhancing and facilitating a new tool or approach. Nurses participating in the interviews thought that the constructs within FamCHAT could be useful for enhancing nursing assessments in their practice, but thought the tool was too long, was repetitive to some of their current assessment data, and had questions many patients were uncomfortable answering. One option suggested in both focus groups was to embed the most useful constructs into existing assessment frameworks. Some of the variables were thought to be of limited relevancy for some nursing specialties. Conclusions: The findings provided valuable information for the hospital management in their efforts to revise nursing assessment tools. Consideration is being given to integrating some of the constructs into their existing nursing assessment, with recognition that each unit might benefit from different approaches. Other, systematic, approaches to enhancing cultural competency also need to be considered. This study highlights the importance of validating practice tools for use in settings that differ from those used for their original development.

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    Article (Published)
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    Attribution 3.0 International
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    • Higginbottom GMA, Richter S, Young S, Ortiz L, Callendar S, Forgeron J, and Boyce M. (2012). Evaluating the utility of the FamCHAT ethnocultural nursing assessment tool at a Canadian tertiary care hospital: a pilot study with recommendations for hospital management. Journal of Nursing Education and Practice, 2(2), 24-40. DOI: 10.5430/jnep.v2n2p24 .