Kahn-John, M. (2014). The Factor Structure of Six Cultural Concepts on Psychological Distress and Health Related Quality of Life in a Southwestern American Indian Tribe, (Doctoral dissertation, University of Colorado Anschutz Medical Campus. Strauss Health Sciences Library).
Abstract
This secondary analysis of data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) study (Beals, Manson, Mitchell, Spicer, and the AI-SUPERPFP Team, 2003) explored factor structure of six cultural concepts (spirituality, respect, reciprocity, relationship, thinking, discipline) in a Southwestern American Indian (AI) Tribe. The relationships of these underlying factors with psychological distress and health related quality of life were then explored.
The purpose of this study was to highlight concepts in AI culture and to determine their relationships with two common assessments of health among members of a Southwest AI Tribe. The primary investigator sought to determine agreement by cultural experts who evaluated items, selected from a pre-existing database, that potentially reflected the six concepts under review; discover the factor structure of the resulting items; and to determine if a relationship existed between the concept factors and outcomes of psychological distress and health related quality of life in a Southwestern AI tribe. Literature reviewed on the present state of AI health highlighted the present-day health disparities, historical trauma, models of resilience, AI protective factors and led to development of a model modifying the work of Gunnestad. Exploratory factor analysis, confirmatory factor analysis, and path analysis were conducted on the original sample of 1446 subjects. A 3-factor structure provided the best fitting model. The latent variables were Harmony, Spirituality, and Respect. The health related quality of life measure used separated out physical and mental component summaries (PCS and MCS, respectively). Significant relationships were discovered between Respect and the MCS (β=0.382), Respect and the PCS
(β=0.310), Respect and psychological distress (β=-0.392), Spirituality and the PCS (β=- 0.09). No significant relationships found between Harmony and psychological distress or health related quality of life.
Conclusions were that these AI cultural concepts had significant relationships with psychological distress and health related quality of life in a Southwest AI Tribe. Further investigation of cultural concepts is warranted for the development of culturally relevant instruments and health promotion interventions for AI populations.