THE EFFECT OF CROSS-CULTURAL TRAINING ON CROSS-CULTURAL SKILLS, ADJUSTMENT

297 Pages·1998·18.02 MB·English

THE EFFECT OF CROSS-CULTURAL TRAINING
ON CROSS-CULTURAL SKILLS, ADJUSTMENT, AND PERFORRlANCE
IN A TIRANSCULTURAL NüRSING CONTEXT
Sharon Nancy Leiba
A thesis submitted in conformity with the requirernents
for the degree of Doctor of Philosophy in Management
Graduate Department of Management
University of Toronto
Q Copyright by Sharon Nancy Leiba, 1997
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THE EFFECT OF CROSS-CmTURAL TRAINING ON CROSS-CULTURAL
SKILLS, ADJUSTMENT, AND PERFORMANCE IN A TRANSCULTURAL
NURSING CONTEXT
Sharon Nancy Leiba
Doctor of Phiiosophy in Management, 1997
Facdty of Management, University of Toronto
ABSTRACT:
This thesis examines the effects of information-based versus experientially-based cross-
cultural (C/C) training programs on the adjustment and performance of nurses in a domestic
transcultural nursing context. Mediaihg and moderating constnicts were derived fiom the
international C/C management titerature and Social Cognitive Theory (Bandura, 1986). Mediating
constmcts include the nurse's C/C self-efficacy regardmg (1) the effective application of her
c h a lk nowledge (hypothesized to mediate the relationship between C/C training rigor & C/C
adjustment) and (2) her ability to perform mteractive nursing activities with culturaUy-Merent
patients (hypothesized to mediate the relationship between C/C training rigor & CM:
performance). Moderatmg constmcts mclude perceptual fledility (Le., tolerance for the
paxticular kind of ambiguity that is posed by transcdtural situations; hypothesized to moderate
the relationship between C/C training rigor & each type of C/C self-efficacy), cultural-distance
(ie ., between nurses and their patients; hypothesized to moderate the relationship between each
type of C/C self-efficacy & its correspondmg outcome of C/C adjustment or performance), and
intensity of mteraction (ie., fiequency and breadth of the mteractions required by nurses with
patients of diverse medicai conditions; a h h ypothesized to rnoderate the relationship between
each type of C/C self- efficacy & its correspondhg outcome of C/C adjustment or performance).
These relationships were examined via a quasi-experimentai cross-sectional design m 9
Toronto hospitals. Subjects ( 148 staff nurses & their supervûon) completed questionnaires with
reliable measures that tapped into the constmcts of mterest. Self & supervisor performance
appraisais were sought.
Results partially supported the hypothesized modeL Theoretical implications included:
( 1) the positive effect of CIC trasimg on C/Cp erformance generalizes to a domestic C/C context;
(2) the pontive effect of C/C training on C/C adjustment does not generalize to an
environmentauy-turbulent, domestic CIC context; (3) C/C skills may be effectively
operationalized m the form of C/C self-efficacy; (4) these two operationaikations of C/C self-
efficacy are differentiaiiy related to C/C training and performance; (5) prior C/C exposure
facilitates transfer of training hsofar as the exposure is contextually similar to the work
environment, and (6) perceptual fiexibdity is significantly correlated to C/C adjustment and
performance but does not mipede leammg. The key practical implication is that C/C training can
improve nurses' C/C performance.
ACKNOWLEDGEMENTS
The author gratefully acknowledges the invaluable support and assistance
provided by her supervisor, Dr. Dan Ondrack, and the members of her thesis cornmittee,
Dr. Martin Evans and Dr. Diane Irvine. The author also wishes to thank her famity for
contributing to her awareness of the importance of cross-cultural training to society.
Fiiaiiy, speeial thanks go to Ahn O'Sullivan, who has helped to ensure that cross-cultural
communication wül remain a treasured, Melong pastirne.
TABLE of CONTENTS
PAGE
CEAPTER
i
1. Background
10
2. Transcultural Nursmg
28
3. Cross-cultural Management
62
4. Synthesis
74
5. Methodology
119
6. Resdts & Discussion
148
7. Sumrnary & Conclusions
162
References
LIST OF TABLES
TABLE PAGE
1. Immigration to Canada by Country of Birth, 196% 1990.
2. Summary ofTransculhiral Nursiog Care Models
2(A). Types and Redictors
2(B). Expected Outcornes, Proposed Sohitions
2(C). Unanswered Questions
3. Jackson's Dimensions of Major Cultural Health Beliefi
3(A). DeWon, Cause, and Contagion
3(B). Diagnosis, Treatment, Profde of Curer, Revtmtion
4. Definitions of C/C Adjustment and Performance
5. Taxonomies of C/C Skills
6. Various Classifications of C/C Training Methods
7. Dimensions of Culture Content
8. Sample Breakdown by Hospital Unit and Level of CCT Rigor
9. C/C Initiatives by Hospital
IO. Demographics of Entire Sample of Staff Nurses
1 1. Prior Exposure to C/C DNersity
12. CNO Statistics for RN's and RNA's vs. Statistics for This Study
13. Descriptive and Psychometric Data for Measures of Cultural-
Knowledge Self-efficacy, C/C Relationship Self-efficacy,
Strain, Satisfaction, and Performance
14. Surnmary of Constmcts and their Measures
15. Correlations among Variables used in the Analysis
16. Main Effects as a Function of Level of C/CT raining Rigor
(Degree of Exp eriential ActMty)
TABLE PAGE
17. Main Effects as a Function of Level of Chal-Knowledge 20 1
Self-Efficacy and C/C Relationship self-efficacy
18. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
-
Adjustment (Satisfaction with Patients Controlling for
Satisfaction m General)
19. Regression Analysis for H 1 & H3: Effect of CCT Rigor on C/C
-
Adjustment (Satisfaction with Patients NOT Controhg
for Satisfaction in General)
20. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
Adjustment (Frequency of Stress with Culturally-Different
-
Patients Controlling for SIG)
2 1. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
Adjustment (Frequency of Stress with Culturaify-Different
-
Patients NOT Controbg for SIG)
22. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
Adjustment (Frequency of Stress with Patients in General -
Controlling for SIG)
23. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
-
Adjustment (Frequency of Stress with Patients m General
NOT Controlling for SIG)
24. Regression Analysis for Hl & H3: Effect of CCT Rigor on CIC
Adjustment (Intensity of Stress with Culturally-Different
-
Patients Controhg for SIG)
25. Regression Analysis for Hl & H3: Effect of CCT Rigor on C/C
Adjustment (Intennty of Stress with Cufturdy-Different
Patients - NOT Controlhg for SIG)
TABLE PAGE
26. Regression Analysis for H 1 & H3 : Effect of CCT Rigor on CIC 206
Adjustment (Intensity of Stress with Patients in General-
ControUing for SIG)
27. Regression Analysis for Hl & H3: Effect of CCT Rigor on CIC
Adjustment(Intensity of Stress with Patients m General-
NOT Controlling for SIG)
28. Regression Analysis for II2 & H4:
Effect of CCT Rigor on CIC Performance (Self-Appraisals)
29. Regession Analysis for H2 & H4:
Effect of CCT Rigor on C/C Performance (Peer Appraisals)
3 0. Regression Analysis for H2 & H4:
Effect of CCT Rigor on C/C Performance (Aggregate and
1: 1 Sup ervisor App raids)
3 1. Regression Analysis for H2 & H4:
Effect of CCT Rigor on C/C Performance (1: 1 Supervisor
Appraisals)
32 . Regression Analysis for H5 & H7:
Effect of CCT Rigor on Cultural-Knowledge SeK-efficacy
33. Regression Analysis for H6 & H8:
Effect of CCT Rigor on CM3 Relationshq Self-efficacy
34. Regression Analysis for Hg:
Effect of Cultural-knowledge self-eficacy on C/C
Adjustment (Satisfaction with Patients - controhg for
SATG)
3 5. Regression Analysis for Hg:
Effect of Cultural-knowledge self-efficacy on C/C
-
Adjustment (Satisfàction with Patients NOT controhg
for SATG)
TABLE PAGE
36. Regression Anaiysis for Hg: 211
Effect of Cultural-knowledge self-efficacy on C/C
Adjument (Frequency of Stress with Culturdy-Different
-
Patients Controihg for SIG)
37. Regression Analysk for Hg:
Effect of Cdturd-knowledge self-efficacy on C/C
Adjustment (Frequency of Stress with Patients m General-
Controlling for SIG)
38. Regression Analysis for H9:
Effect of Cultural-knowledge self-efficacy on CIC
Adjustment (Intensity of Stress with Culturally-DBerent
-
Patients Controllhg for SIG)
39. Regression Analysis for Hg:
Effect of Cultural-knowledge ~e~efficaocny CIC
-
Adjustment (Intensity of Stress with Patients in General
Controlling for SIG)
40. Regression Analysis for H10:
Effect of CIC Relationship Self-Efficacy on CIC
Performance (S elf-A ppraisals)
4 1. Regression Andysis for H 10:
Effect of C/C Relationship Self-Efficacy on CIC
Performance (Peer-Appraisals)
12. Regression Analysis for H10:
Effect of C/C Relationship Self-Efficacy on CIC
Performance (Aggregate and 1: 1 Supenisor Appraisals)
43. Regression Analysis for H10:
Effect of C/C Relationship Se*Efficacy on
Performance ( 1: 1 Sup eMsor Ap praisals)