Health Care for Women International
ISSN: 0739-9332 (Print) 1096-4665 (Online) Journal homepage: http://www.tandfonline.com/loi/uhcw20
Measurement issues in the use of the Coopersmith self‐esteem inventory with Navajo women Patricia G. Higgins PhD, RN & Elisabeth K. Dicharry MS, RNC To cite this article: Patricia G. Higgins PhD, RN & Elisabeth K. Dicharry MS, RNC (1990) Measurement issues in the use of the Coopersmith self‐esteem inventory with Navajo women, Health Care for Women International, 11:3, 251-262, DOI: 10.1080/07399339009515896 To link to this article: http://dx.doi.org/10.1080/07399339009515896
Published online: 14 Aug 2009.
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Date: 07 November 2015, At: 04:08
MEASUREMENT ISSUES IN THE USE OF THE COOPERSMITH SELF-ESTEEM INVENTORY WITH NAVAJO WOMEN Patricia G. Higgins, PhD, RN College of Nursing, University of New Mexico
Elisabeth K. Dicharry, MS, RNC Downloaded by [Deakin University Library] at 04:08 07 November 2015
University of New Mexico Hospital
In this article the authors describe the measurement error associated with the Coopersmith Self-Esteem Inventory when used with a population of Navajo women. This instrument was used with 29 Navajo women to determine if the questions were culturally acceptable. The results showed that this instrument has some content validity issues when used with Navajo women. More research is needed using this instrument as well as other psychometrically sound selfesteem measures with cultural and racial groups other than whites.
Although the concept of self-esteem has received considerable attention in the literature of the social and behavioral sciences, few studies have attempted to define and measure self-esteem for Native Americans, particularly women. The purpose of this study was to establish content validity for Native American women of the widely accepted and used Coopersmith Self-Esteem Inventory (SEI). To accurately measure selfesteem in a Native American population, it was necessary to identify the measurement issues for the SEI using an ethnonursing framework applied to a sample of Navajo women (Aamodt, 1979; Leininger, 1978). MODEL Leininger (1978) defines ethnonursing as the systematic study of beliefs, values, and practices as they are perceived by a designated culture through their languages, experiences, and values. Ethnonursing research reflects the client's viewpoint of knowing and experiencing health care. By studying the indigenous views for a particular culture, validity and reliability measurement issues may empirically predict the needs of a specific cultural group. Fundamental to the ethnonursing model is the Health Care for Women International 11:251-262, 1990 Copyright © 1990 by Hemisphere Publishing Corporation
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concept of comparative human behaviors; that is, how people are similar and how they are different. In order to respond most effectively to the needs of a cultural group, an appraisal of a cultural belief system is necessary. Leininger asserts that the greater the differences between the indigenous cultural values and modern health care values, the greater the signs of cultural conflict and stresses between care receiver and care provider. Understanding the cultural context for a particular concept such as self-esteem is important for health care providers, who may be tempted to transfer the concept developed from one cultural setting to another and expect the same results. LITERATURE REVIEW For the Anglo-white population, the self is defined as a picture of oneself or self-awareness. The picture or awareness develops from the experiences the person can attribute to his or her own body or to the results of personal behavior. Since these experiences have values attached, some aspects of the self-picture are positive, while others are negative (Patten, 1981; Rosenberg, 1965; Wylie, 1974). Most theorists agree that self-esteem is a learned phenomenon involving a lifelong process that revolves around the interaction of the individual with the social environment and significant others (Coopersmith, 1967; Crouch & Straub, 1983; Stanwyck, 1983). Crouch and Straub (1983) distinguished between basic self-esteem, the relatively enduring foundation formed early through life experiences, and functional self-esteem, which develops later in life through an ongoing evaluation of interactions with others. Functional self-esteem is considered changeable and may substantially exceed basic self-esteem. According to Stanwyck (1983), selfesteem in adulthood is a reflection of social relationships and career development. Self-esteem has been linked to positive health practices, a sense of mastery, and effective coping behaviors (Caplan, 1981; Mercer et al., 1986; Mulenkamp & Sayles, 1986; Pearlin & Schooler, 1978). The Navajo word for self-esteem is 'adil' idj'. The term means what one thinks of oneself. Little has been written about the concept of selfesteem among Navajos (Young & Morgan, 1980). However, a description of the Navajo family and culture offers insight into the concept of self-esteem from a Native American perception. Navajo traditions are enriched by healing ceremonies, squaw dances, and intimate gatherings. A healing ceremony, held for a sick family member, can last as long as nine days. Many people may come to these ceremonies, and the family giving the ceremony is expected to feed everyone who comes. It is an ancient tradition to be generous to friends who visit and it is done with-
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out regret (Ashabranner, 1984; Dutton, 1983). Thus interaction with family and participation in ceremonies apparently foster self-esteem. Historically, sobriety, self-control, and adherence to old customs are valued. Women are praised when they do not cry. Anger, "bad talk," and quarrels should be avoided, especially in front of those outside the immediate family. The Navajo is raised with the premise of behaving with everyone as if they were relatives (Kluckhohn, 1964). Specific virtues of personal independence, cooperation, autonomy, truthfulness, trustworthiness, obedience to parents, control over impulses, pity for loneliness and distress, and fluency in speech are prized (Kluckhohn, 1964). Hobson (1954) interviewed 77 Navajo informants aged 15 years or more and found recurrent positive themes related to self—"make a good living," "have lots of property," "take care of things," "look after your family," and "help people out." These themes of health, wealth, and security are central in Navajo ethics. The individual has the right to his or her own decisions (autonomy), and comments such as, "it is their business, not mine," are common. Navajos generally do not object to an individual's behavior because gossiping is not allowed (Lamphere, 1977) and in a situation where behavior is viewed as negative, the individual offers help and cooperates with the person to seek a solution. A good appearance is also valued. This is partly a matter of physique, figure, and facial appearance, and it means more than dressing well. Possessions are valued both as providing security and as affording opportunities for mild ostentations. Riches, as the chief aim of life, are universally condemned (Kluckhohn & Leighton, 1960). One should be honest and cheating is wrong. Personal excellence is a value, but personal success is not. Self-esteem as a concept has meaning and dimension for the Navajos and needs to be studied from their cultural perspective. However, very little research has been conducted on this concept with Navajo women. METHOD Sample The sample for this exploratory, descriptive study consisted of 29 Navajo women recruited and interviewed by a Navajo-speaking nurse. Participants (a) spoke fluent Navajo, (b) were between 15 and 69 years of age, (c) resided on the New Mexico or Arizona reservations, and (d) were known by the interviewer or the interviewer's family. All the women were informed of the voluntary nature of the study, that re-
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sponses would be confidential, and that the overall purpose of the study was ultimately to develop a self-esteem inventory to be used with Native Americans. Navajo men were not included in this study. The researchers wanted to study the topic from a female perspective using a female interviewer familiar with the matrilineal kinship structure of the society. The 29 women in the sample included 27 Navajo women from New Mexico and 2 from Arizona (Table 1). Except for 2 women from Gallup, NM, all the participants resided in rural sections of the Navajo reservation. Women ranged in age from 15 to 69. Ten women were married and 19 were unmarried. Navajo was the primary language of 14 women, 9 were bilingual (English and Navajo), and 6 preferred to speak English. Nine women practiced traditional Navajo religious beliefs or were members of the Native American Church, while 12 women held western religious beliefs, and 8 had no religious preference. Twenty-two women completed high school or went to college while 2 had no formal education. Twenty-three received no public assistance and 6 received public assistance. Twenty-one were employed and 8 were unemployed. Twenty women had incomes below $10,000. Instrument The Coopersmith Self-Esteem Inventory (SEI) contains 25 item statements to which the subject indicates either "like me" or "unlike me." For the Anglo-white population, SEI Cronbach's alpha has been reported to be .74 for males and females, respectively (Bedeilan, Geagud, & Zmud, 1977). These findings are similar to those of Frerichs (1973), who obtained a 4 week test-retest reh'ability coefficient of .85. Convergent validity coefficients fall into the acceptable range, according to Robinson and Shaver (1973), who indicated that the SEI's sensitivity to a socially desirable response set is a weakness shared with almost all measures of self-esteem. Crandall (1973) listed the SEI within the top five self-esteem scales for perceived overall quality and stated that it took less than 10 minutes to administer. The Tennessee Self-Concept Scale, a self-administered scale of 100 items, measures self-concept including level of adjustment and personality disorders (Fitts, 1965). This instrument is often used with groups of school children, student nurses, and adults and is self administered. It also requires at least an hour to accurately respond to the questions. For this reason, the instrument was not considered appropriate for this study. The Rosenberg Self-Esteem Scale is a 10 item self-report measure of the self-acceptance aspect of self-esteem (Rosenberg, 1965). Although the instrument's reliability data were satisfactory (test-retest over a 2
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Table 1. Demographic Characteristics of 29 Participants in the Study
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Variable Location Iyanbito, NM Gallup, NM Churchrock, NM Pinedale, NM Navajo Reservation, NM Navajo Reservation, AZ Age in years 15-19 20-29 30-39 40-49 . 50-59 60-69 Education College graduate Some college High school graduate No formal education Unknown Income < $5,000 5,000- 7,499 7,500- 9,999 10,000-14,999 15,000-19,999 25,000-34,999 Unknown Marital Status Married Single Single, but living with a partner Divorced Widowed Language Navajo Bilingual English Religion Traditional Navajo beliefs Mormon Protestant Catholic Native American Church No religious preference
n
10 4 2 2 9 2
-
2 8 13 3 1 2 2 10 10 2 5 14 4 2 1 1 5 2 10 8 5 4 2 14 9 6 6 5 4 3 3 8
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week period = .85), the instrument was considered too narrow in scope for this study because it focused on only one aspect of self-esteem. Coopersmith (1967) tested 85 white males, aged 10-12 years, using various standard self-rating and projective tests, and conducted extensive interviews with both the subjects and their mothers. In summarizing his results, he identified three major antecedents of self-esteem: (a) parental acceptance of their children; (b) clearly defined and enforced parental limits, and (c) parental self-esteem. Coopersmith's conclusions placed the total emphasis on interactions with significant others as the antecedents of self-esteem. The Coopersmith SEI measurement error has not been addressed in any of the reported Coopersmith studies. However, the simple dichotomies of "like me" and "unlike me" may suggest the possibility of measurement error due to lack of precision. The use of the SEI with Hispanic or Indian populations was not reported in the published literature. It seemed appropriate to use the SEI with Navajo women, however, because of its social interactive qualities. Procedure A Navajo-speaking nurse interviewed 29 Navajo women from her clan (her own matrilineal blood line). This protocol respected the Navajo belief of "keeping things in the family." A major problem with research when the investigator must rely on a native speaker to do the interviewing is that informants will sometimes give the "ideal" response, or one that they believe someone from their own culture would think proper in light of cultural values the informant is expected to reflect, especially those that refer to conceit or insult. The women were asked 25 questions from the SEI. They were instructed to respond if each question was acceptable and applicable based on Navajo beliefs, values, and attitudes. An 80% level of acceptance was required of each question. If the question did not meet these criteria, the interviewer explored the reasons with the participants. To control translation errors, the interviewer recorded all responses given by the women. The interviews were not taped verbatim because many Navajos believe that their spirit may be captured in tape recordings. FINDINGS The 25 questions on self-esteem from the SEI can be found in Table 2. All questions were assessed for content validity based on Navajo cultural beliefs. Eighteen were perceived as culturally acceptable to the Navajo women. One woman felt that she did not know how to answer question 4 and stated that a "given situation" would be necessary to
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Table 2. Assessing Cultural Relevance of the Coopersmith Self-Esteem Inventory with 29 Navajo Women
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Questions 1. I often wish I were someone else. 2. I find it very hard to talk in front of a g r o u P3. There are lots of things about myself I'd change if I could. 4. I can make up my mind without too much trouble. 5. I'm a lot of fun to be with. 6. I get upset easily at home. 7. It takes me a long time to get used to anything new. 8. I'm popular with persons my own age. 9. My family usually considers my feelings." 10. I give in very easily. 11. My family expects too much of me." 12. It's pretty tough to be me." 13. Things are all mixed up in my life. 14. People usually follow my ideas. 15. I have a low opinion of myself." 16. There are many times when I would like to leave home. 17. I often feel upset with my work. 18. I'm not as nice looking as most people." 19. If I have something to say, I usually say it. 20. My family understands me. 21. Most people are better liked than I am." 22. I usually feel as if my family is pushing me." 23. I often get discouraged with what I am doing. 24. Things usually don't bother me. 25. I can't be depended on.
Culturally acceptable
Culturally unacceptable"
( )
( )
( )
( )
( )
( )
( ) ( ) ( )
( ) ( ) ( )
( ( ( ( ( ( ( ( (
) ) ) ) ) ) ) ) )
( ( ( ( ( ( ( ( (
) ) ) ) ) ) ) ) )
( ( ( ( ( ( (
) ) ) ) ) ) )
( ( ( ( ( ( (
) ) ) ) ) ) )
( ) ( ) ( )
( ) ( ) ( )
"Items not culturally relevant
clarify the question. Depending on the situation, the answer would change. Seven questions were considered culturally unacceptable by 7 (25%) or more Navajo women. Table 3 shows the reasons why the women believed the questions were not relevant in the Navajo culture. Twelve women stated that these 7 questions were personal and hard to answer from their cultural view of family and self. In reply to the ques-
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Table 3. Seven Questions from the Coopersmith Self-Esteem Inventory and Rationale for Why They Were Not Culturally Acceptable to Navajo Women Questions
Comments "Why Not Acceptable"
My family usually considers my feelings
You do not discuss your personal feelings with anyone. I'm not supposed to complain. I'm here to help. It is an insult to ask. This is "not discussed," it is "my business," "no one needs to know." This is an irrelevant question because it shows "conceit" and is an insult to ask. This question causes gossip, which is not nice. It is an insult to ask. These feelings are "not felt" or discussed.
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My family expects too much of me It's pretty tough to be me I have a low opinion of myself I'm not as nice looking as most people
Most people are better liked than I am I usually feel as if my family is pushing me Note. N - 29.
tion of whether "my family usually considers my feelings," the women felt that it is not culturally acceptable to discuss personal feelings with anyone, not even family members. If one felt that the "family expected too much of me," according to Navajo belief, one is not to complain. The role of a Navajo woman is to help others, particularly family members. Hobson (1954) confirmed this value of helping the individual physically and not from a psychosocial framework. In reply to the question "I usually feel as if my family is pushing me," the women viewed this as an insult and these feelings are not to be felt and never discussed with anyone. Talking about the family is considered inappropriate to Navajo women (Kluckhohn, 1964). One would be viewed as a complainer if one perceived that "it's pretty tough to be me." The women felt that asking the question as worded in the SEI was an insult. If one has a "low opinion of myself," this is not discussed since feelings are kept "inside" and are not shared with others. This supports Kluckhohn's (1964) study when he viewed the Navajo people as stoic, inward, and not sharing of their inner thoughts and feelings. The concept of "pretty" or "nice looking" is not appropriate to ask a Navajo woman since this would allow her to focus on herself, which is against her cultural beliefs and shows conceit. The focus is on others
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and helping others and not on oneself. The Navajo people have long, beautiful black hair. Turquoise jewelry adorns fingers, hands, arms, head, neck, and waist, and they take pride in selecting a Navajo Queen each year. However, one is not allowed to claim that he or she is better looking than someone else. Gossip is not allowed in the culture and by asking the question "most people are better liked than I am," this would occur. It is considered "not nice" to gossip about others. This finding supports Lamphere's work (1977) with Navajos and the concept of gossiping. DISCUSSION The Navajo and white cultures view the concept of self-esteem in two distinct, yet similar ways, and it is through research that we begin to understand the concept of self-esteem from a Navajo woman's view of life and self. Seven questions were considered personal or offensive by Navajo women. Six of the questions are worded negatively, "expects too much," "pretty tough," "low opinion," "not nice looking," "most people better liked," "pushing me." These negative questions are contradictory to the Navajo belief system of harmony and sense of balance between the self and environment. In the Navajo culture, the self is constantly striving for harmony (Dutton, 1983) and is viewed in a positive dimension. The family remains the basic unit of the Navajo society and the woman holds the family together (Clark, 1978). The three questions concerning the family were reported as personal and information about the family is not discussed with others. One should never complain, gossip, think negative feelings, or discuss family issues. The self of a woman is defined within her family and from a matrilineal kinship structure. Based on this study, concerns exist about the use of the SEI or any self-esteem measure with Navajo women. The study supports the position that cultural values may influence both the way in which Navajo women respond to a self-esteem measure and the actual meaning of selfesteem within their culture. Traditional beliefs stress the acceptance of natural events and the rejection of others' control. Living as one in harmony with nature, family, and others is emphasized (Chisholm, 1983). These values tend to produce nonintrusive, accepting behavior among Navajo women. Such behavior stands in contrast to the competitive, need-to-excel style that characterizes much of the behavior of white, middle-class Americans (Long, 1983). In using the SEI with Navajo women, several conceptual issues arose. The culture tends to disapprove of positive statements about the self and
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to encourage avoidance of any activities that cause one to stand out from, or excel beyond, one's peer group. Pearlin & Schooler (1978) support this position by noting that the Navajos perceive themselves as "one," and even in times of crisis react as a group, emphasizing response to the needs of the tribe rather than the needs of a specific individual or family. Previous research (Arms, 1985), though not focused specifically on self-esteem, found differences in several personality traits when the results from Indian women were contrasted with those from white or black American women. Thus, findings related to the use of established self-esteem measures with Native American women should be interpreted with caution. In general, the SEI appears to be an internally consistent measure of self-esteem. Some interesting questions may be raised, however, with regard to the scale's interpretation when used with Navajo women. Caplin (1969) demonstrated that self-esteem may be closely tied to many of the demographic variables manifested by the Navajo women in this study, such as age, education, and income. From this research, the authors documented that the SEI as presently structured should be used with caution with Navajo women. Revision of the SEI is needed if researchers plan to use this instrument with other cultural groups besides Anglos. Other instruments that measure selfesteem, such as the Rosenberg Self-Esteem Scale and the Tennessee Self-Concept Scale, need to be tested with other cultures for acceptability and applicability. Further research is needed to determine if selfesteem questions reflect content validity when used with Native Americans. Studies need to address Indian groups throughout North America and to consider results from the SEI as well as other psychometrically sound self-esteem measures. In addition, the differential effects of social environment and ethnic culture on self-esteem need to be examined. The SEI does appear to have some measurement error when used with this sample of Navajo women. Piers (1984) claims that ethnicity alone does not seem to have a major effect on self-esteem scores. Ethnicity, however, implies both a culturally determined set of beliefs about oneself and a social milieu in which there is response to one's ethnicity. Health care providers need to understand each of these aspects in order to achieve an accurate and relevant measure of self-esteem in Native Americans.
REFERENCES Aamodt, A. (1978). Culture. In A. Clark, (Ed.). Culture-childbearing-health professionals (pp. 2-19). Philadelphia: F. A. Davis Company. Arms, P. B. (1985). Prognostic indicators for American Indians treated at U.S. Navy
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alcohol rehabilitation facilities (Doctoral dissertation, United States International University, San Diego, 1985). Dissertation Abstracts International, 46, 1014A. Ashabranner, B. (1984). To live in two worlds. New York: Dodd, Mead, & Co. Bedeilan, A. G., Geagud, B. J., & Zmud, R. W. (1977). Test-retest reliability and internal consistency of the short form of Coopersmith's Self-Esteem Inventory. Psychological Report, 41, 1041-1042. Caplan, G. (1981). Mastery of stress: Psychosocial aspects. American Journal of Psychiatry, 138, 413-420. Caplin, M. D. (1969). The relationship between self-esteem and academic achievement. Journal of Experimental Education, 37(3), 13-16. Chisholm, J. S. (1983). Navajo infancy an ethnological study of child development. New York: Aldine Publishing Company. Clark, A. (Ed.). (1978). Culture-childbearing-health professionals. Philadelphia: F. A. Davis Company. Coopersmith, S. (1967). Antecedents of self-esteem. San Francisco: W. H. Freeman. Crandall, R. (1973). The measurement of self-esteem and related constructs. In J. P. Robinson & P. R. Shaver (Eds.), Measures of social psychological attitudes (rev. ed., pp. 45-67). Ann Arbor: Institute for Social Research, University of Michigan. Crouch, M. S., & Straub, V. (1983). Enhancement of self-esteem in adults. Family and Community Health, 6, 76-78. Dutton, B. (1983). American Indians of the Southwest. Albuquerque: University of New Mexico Press. Fitts, W. H. (1965). Tennessee self-concept scale. Nashville, TN: Counselor Recordings and Tests. Frerichs, M. (1973). Relationship of self-esteem and internal-external control to selected characteristics of associate degree nursing students. Nursing Research, 22, 350-352. Hobson, R. (1954). Navajo acquisitive values. Cambridge, MA: Papers of the Peabody Museum of Archaeology. Kluckhohn, C. (1964). Navajo morals in culture and behavior (pp. 168-176). New York: Free Press (MacMillan Co.). Kluckhohn, C , & Leighton, D. (1960). The Navajo cultural system: An analysis of concepts of cooperation and autonomy and their relation to gossip and witchcraft. In K. Basso & M. Opler (Eds.), Apachean cultural history and ethnology (pp. 91-114). Tucson: University of Arizona Press. Lamphere, L. (1977). To run after him. Tucson: The University of Arizona Press. Leininger, M. (1978). Transcultural nursing, concepts, theories, and practice. New York: John Wiley & Sons. Long, K. A. (1983). The experience of reported and traumatic loss among Crow Indian children: Response patterns and intervention strategies. American Journal of Orthopsychiatry, 53, 116-126. Mercer, R. T., May, K. A., Ferketich, S., & DeJoseph, J. (1986). Theoretical models for studying the effect of antepartum stress on the family. Nursing Research, 35, 339-346. Muhlenkamp, A. F., & Sayles, J. A. (1986). Self-esteem, social support, and positive health practices. Nursing Research, 33, 266-270.
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Patten, M. A. (1981). Self-concept and self-esteem: Factors in adolescent pregnancy. Adolescence, 16(64), 765-778. Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21. Piers, E. V. (1984). Piers-Harris Children's Self-Esteem Scale (Revised Manual), Los Angeles: Western Psychological Services. Robinson, J. P., & Shaver, P. R. (1973). Measures of social psychological attitudes. Ann Arbor: Institute for Social Research, University of Michigan. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press. Stanwyck, D. J. (1983). Self-esteem through the life span. Family and Community
Health, 6, 11-28. Wylie, R. C. (1974). The self-concept. Vol. /(rev. ed.). Lincoln: University of Nebraska Press. Young, R. W., & Morgan, W. (1980). The Navajo language a grammar and colloquial dictionary. Albuquerque: University of New Mexico Press.
ISSN: 0739-9332 (Print) 1096-4665 (Online) Journal homepage: http://www.tandfonline.com/loi/uhcw20
Measurement issues in the use of the Coopersmith self‐esteem inventory with Navajo women Patricia G. Higgins PhD, RN & Elisabeth K. Dicharry MS, RNC To cite this article: Patricia G. Higgins PhD, RN & Elisabeth K. Dicharry MS, RNC (1990) Measurement issues in the use of the Coopersmith self‐esteem inventory with Navajo women, Health Care for Women International, 11:3, 251-262, DOI: 10.1080/07399339009515896 To link to this article: http://dx.doi.org/10.1080/07399339009515896
Published online: 14 Aug 2009.
Submit your article to this journal
Article views: 6
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=uhcw20 Download by: [Deakin University Library]
Date: 07 November 2015, At: 04:08
MEASUREMENT ISSUES IN THE USE OF THE COOPERSMITH SELF-ESTEEM INVENTORY WITH NAVAJO WOMEN Patricia G. Higgins, PhD, RN College of Nursing, University of New Mexico
Elisabeth K. Dicharry, MS, RNC Downloaded by [Deakin University Library] at 04:08 07 November 2015
University of New Mexico Hospital
In this article the authors describe the measurement error associated with the Coopersmith Self-Esteem Inventory when used with a population of Navajo women. This instrument was used with 29 Navajo women to determine if the questions were culturally acceptable. The results showed that this instrument has some content validity issues when used with Navajo women. More research is needed using this instrument as well as other psychometrically sound selfesteem measures with cultural and racial groups other than whites.
Although the concept of self-esteem has received considerable attention in the literature of the social and behavioral sciences, few studies have attempted to define and measure self-esteem for Native Americans, particularly women. The purpose of this study was to establish content validity for Native American women of the widely accepted and used Coopersmith Self-Esteem Inventory (SEI). To accurately measure selfesteem in a Native American population, it was necessary to identify the measurement issues for the SEI using an ethnonursing framework applied to a sample of Navajo women (Aamodt, 1979; Leininger, 1978). MODEL Leininger (1978) defines ethnonursing as the systematic study of beliefs, values, and practices as they are perceived by a designated culture through their languages, experiences, and values. Ethnonursing research reflects the client's viewpoint of knowing and experiencing health care. By studying the indigenous views for a particular culture, validity and reliability measurement issues may empirically predict the needs of a specific cultural group. Fundamental to the ethnonursing model is the Health Care for Women International 11:251-262, 1990 Copyright © 1990 by Hemisphere Publishing Corporation
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concept of comparative human behaviors; that is, how people are similar and how they are different. In order to respond most effectively to the needs of a cultural group, an appraisal of a cultural belief system is necessary. Leininger asserts that the greater the differences between the indigenous cultural values and modern health care values, the greater the signs of cultural conflict and stresses between care receiver and care provider. Understanding the cultural context for a particular concept such as self-esteem is important for health care providers, who may be tempted to transfer the concept developed from one cultural setting to another and expect the same results. LITERATURE REVIEW For the Anglo-white population, the self is defined as a picture of oneself or self-awareness. The picture or awareness develops from the experiences the person can attribute to his or her own body or to the results of personal behavior. Since these experiences have values attached, some aspects of the self-picture are positive, while others are negative (Patten, 1981; Rosenberg, 1965; Wylie, 1974). Most theorists agree that self-esteem is a learned phenomenon involving a lifelong process that revolves around the interaction of the individual with the social environment and significant others (Coopersmith, 1967; Crouch & Straub, 1983; Stanwyck, 1983). Crouch and Straub (1983) distinguished between basic self-esteem, the relatively enduring foundation formed early through life experiences, and functional self-esteem, which develops later in life through an ongoing evaluation of interactions with others. Functional self-esteem is considered changeable and may substantially exceed basic self-esteem. According to Stanwyck (1983), selfesteem in adulthood is a reflection of social relationships and career development. Self-esteem has been linked to positive health practices, a sense of mastery, and effective coping behaviors (Caplan, 1981; Mercer et al., 1986; Mulenkamp & Sayles, 1986; Pearlin & Schooler, 1978). The Navajo word for self-esteem is 'adil' idj'. The term means what one thinks of oneself. Little has been written about the concept of selfesteem among Navajos (Young & Morgan, 1980). However, a description of the Navajo family and culture offers insight into the concept of self-esteem from a Native American perception. Navajo traditions are enriched by healing ceremonies, squaw dances, and intimate gatherings. A healing ceremony, held for a sick family member, can last as long as nine days. Many people may come to these ceremonies, and the family giving the ceremony is expected to feed everyone who comes. It is an ancient tradition to be generous to friends who visit and it is done with-
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out regret (Ashabranner, 1984; Dutton, 1983). Thus interaction with family and participation in ceremonies apparently foster self-esteem. Historically, sobriety, self-control, and adherence to old customs are valued. Women are praised when they do not cry. Anger, "bad talk," and quarrels should be avoided, especially in front of those outside the immediate family. The Navajo is raised with the premise of behaving with everyone as if they were relatives (Kluckhohn, 1964). Specific virtues of personal independence, cooperation, autonomy, truthfulness, trustworthiness, obedience to parents, control over impulses, pity for loneliness and distress, and fluency in speech are prized (Kluckhohn, 1964). Hobson (1954) interviewed 77 Navajo informants aged 15 years or more and found recurrent positive themes related to self—"make a good living," "have lots of property," "take care of things," "look after your family," and "help people out." These themes of health, wealth, and security are central in Navajo ethics. The individual has the right to his or her own decisions (autonomy), and comments such as, "it is their business, not mine," are common. Navajos generally do not object to an individual's behavior because gossiping is not allowed (Lamphere, 1977) and in a situation where behavior is viewed as negative, the individual offers help and cooperates with the person to seek a solution. A good appearance is also valued. This is partly a matter of physique, figure, and facial appearance, and it means more than dressing well. Possessions are valued both as providing security and as affording opportunities for mild ostentations. Riches, as the chief aim of life, are universally condemned (Kluckhohn & Leighton, 1960). One should be honest and cheating is wrong. Personal excellence is a value, but personal success is not. Self-esteem as a concept has meaning and dimension for the Navajos and needs to be studied from their cultural perspective. However, very little research has been conducted on this concept with Navajo women. METHOD Sample The sample for this exploratory, descriptive study consisted of 29 Navajo women recruited and interviewed by a Navajo-speaking nurse. Participants (a) spoke fluent Navajo, (b) were between 15 and 69 years of age, (c) resided on the New Mexico or Arizona reservations, and (d) were known by the interviewer or the interviewer's family. All the women were informed of the voluntary nature of the study, that re-
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sponses would be confidential, and that the overall purpose of the study was ultimately to develop a self-esteem inventory to be used with Native Americans. Navajo men were not included in this study. The researchers wanted to study the topic from a female perspective using a female interviewer familiar with the matrilineal kinship structure of the society. The 29 women in the sample included 27 Navajo women from New Mexico and 2 from Arizona (Table 1). Except for 2 women from Gallup, NM, all the participants resided in rural sections of the Navajo reservation. Women ranged in age from 15 to 69. Ten women were married and 19 were unmarried. Navajo was the primary language of 14 women, 9 were bilingual (English and Navajo), and 6 preferred to speak English. Nine women practiced traditional Navajo religious beliefs or were members of the Native American Church, while 12 women held western religious beliefs, and 8 had no religious preference. Twenty-two women completed high school or went to college while 2 had no formal education. Twenty-three received no public assistance and 6 received public assistance. Twenty-one were employed and 8 were unemployed. Twenty women had incomes below $10,000. Instrument The Coopersmith Self-Esteem Inventory (SEI) contains 25 item statements to which the subject indicates either "like me" or "unlike me." For the Anglo-white population, SEI Cronbach's alpha has been reported to be .74 for males and females, respectively (Bedeilan, Geagud, & Zmud, 1977). These findings are similar to those of Frerichs (1973), who obtained a 4 week test-retest reh'ability coefficient of .85. Convergent validity coefficients fall into the acceptable range, according to Robinson and Shaver (1973), who indicated that the SEI's sensitivity to a socially desirable response set is a weakness shared with almost all measures of self-esteem. Crandall (1973) listed the SEI within the top five self-esteem scales for perceived overall quality and stated that it took less than 10 minutes to administer. The Tennessee Self-Concept Scale, a self-administered scale of 100 items, measures self-concept including level of adjustment and personality disorders (Fitts, 1965). This instrument is often used with groups of school children, student nurses, and adults and is self administered. It also requires at least an hour to accurately respond to the questions. For this reason, the instrument was not considered appropriate for this study. The Rosenberg Self-Esteem Scale is a 10 item self-report measure of the self-acceptance aspect of self-esteem (Rosenberg, 1965). Although the instrument's reliability data were satisfactory (test-retest over a 2
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Table 1. Demographic Characteristics of 29 Participants in the Study
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Variable Location Iyanbito, NM Gallup, NM Churchrock, NM Pinedale, NM Navajo Reservation, NM Navajo Reservation, AZ Age in years 15-19 20-29 30-39 40-49 . 50-59 60-69 Education College graduate Some college High school graduate No formal education Unknown Income < $5,000 5,000- 7,499 7,500- 9,999 10,000-14,999 15,000-19,999 25,000-34,999 Unknown Marital Status Married Single Single, but living with a partner Divorced Widowed Language Navajo Bilingual English Religion Traditional Navajo beliefs Mormon Protestant Catholic Native American Church No religious preference
n
10 4 2 2 9 2
-
2 8 13 3 1 2 2 10 10 2 5 14 4 2 1 1 5 2 10 8 5 4 2 14 9 6 6 5 4 3 3 8
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week period = .85), the instrument was considered too narrow in scope for this study because it focused on only one aspect of self-esteem. Coopersmith (1967) tested 85 white males, aged 10-12 years, using various standard self-rating and projective tests, and conducted extensive interviews with both the subjects and their mothers. In summarizing his results, he identified three major antecedents of self-esteem: (a) parental acceptance of their children; (b) clearly defined and enforced parental limits, and (c) parental self-esteem. Coopersmith's conclusions placed the total emphasis on interactions with significant others as the antecedents of self-esteem. The Coopersmith SEI measurement error has not been addressed in any of the reported Coopersmith studies. However, the simple dichotomies of "like me" and "unlike me" may suggest the possibility of measurement error due to lack of precision. The use of the SEI with Hispanic or Indian populations was not reported in the published literature. It seemed appropriate to use the SEI with Navajo women, however, because of its social interactive qualities. Procedure A Navajo-speaking nurse interviewed 29 Navajo women from her clan (her own matrilineal blood line). This protocol respected the Navajo belief of "keeping things in the family." A major problem with research when the investigator must rely on a native speaker to do the interviewing is that informants will sometimes give the "ideal" response, or one that they believe someone from their own culture would think proper in light of cultural values the informant is expected to reflect, especially those that refer to conceit or insult. The women were asked 25 questions from the SEI. They were instructed to respond if each question was acceptable and applicable based on Navajo beliefs, values, and attitudes. An 80% level of acceptance was required of each question. If the question did not meet these criteria, the interviewer explored the reasons with the participants. To control translation errors, the interviewer recorded all responses given by the women. The interviews were not taped verbatim because many Navajos believe that their spirit may be captured in tape recordings. FINDINGS The 25 questions on self-esteem from the SEI can be found in Table 2. All questions were assessed for content validity based on Navajo cultural beliefs. Eighteen were perceived as culturally acceptable to the Navajo women. One woman felt that she did not know how to answer question 4 and stated that a "given situation" would be necessary to
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Table 2. Assessing Cultural Relevance of the Coopersmith Self-Esteem Inventory with 29 Navajo Women
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Questions 1. I often wish I were someone else. 2. I find it very hard to talk in front of a g r o u P3. There are lots of things about myself I'd change if I could. 4. I can make up my mind without too much trouble. 5. I'm a lot of fun to be with. 6. I get upset easily at home. 7. It takes me a long time to get used to anything new. 8. I'm popular with persons my own age. 9. My family usually considers my feelings." 10. I give in very easily. 11. My family expects too much of me." 12. It's pretty tough to be me." 13. Things are all mixed up in my life. 14. People usually follow my ideas. 15. I have a low opinion of myself." 16. There are many times when I would like to leave home. 17. I often feel upset with my work. 18. I'm not as nice looking as most people." 19. If I have something to say, I usually say it. 20. My family understands me. 21. Most people are better liked than I am." 22. I usually feel as if my family is pushing me." 23. I often get discouraged with what I am doing. 24. Things usually don't bother me. 25. I can't be depended on.
Culturally acceptable
Culturally unacceptable"
( )
( )
( )
( )
( )
( )
( ) ( ) ( )
( ) ( ) ( )
( ( ( ( ( ( ( ( (
) ) ) ) ) ) ) ) )
( ( ( ( ( ( ( ( (
) ) ) ) ) ) ) ) )
( ( ( ( ( ( (
) ) ) ) ) ) )
( ( ( ( ( ( (
) ) ) ) ) ) )
( ) ( ) ( )
( ) ( ) ( )
"Items not culturally relevant
clarify the question. Depending on the situation, the answer would change. Seven questions were considered culturally unacceptable by 7 (25%) or more Navajo women. Table 3 shows the reasons why the women believed the questions were not relevant in the Navajo culture. Twelve women stated that these 7 questions were personal and hard to answer from their cultural view of family and self. In reply to the ques-
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Table 3. Seven Questions from the Coopersmith Self-Esteem Inventory and Rationale for Why They Were Not Culturally Acceptable to Navajo Women Questions
Comments "Why Not Acceptable"
My family usually considers my feelings
You do not discuss your personal feelings with anyone. I'm not supposed to complain. I'm here to help. It is an insult to ask. This is "not discussed," it is "my business," "no one needs to know." This is an irrelevant question because it shows "conceit" and is an insult to ask. This question causes gossip, which is not nice. It is an insult to ask. These feelings are "not felt" or discussed.
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My family expects too much of me It's pretty tough to be me I have a low opinion of myself I'm not as nice looking as most people
Most people are better liked than I am I usually feel as if my family is pushing me Note. N - 29.
tion of whether "my family usually considers my feelings," the women felt that it is not culturally acceptable to discuss personal feelings with anyone, not even family members. If one felt that the "family expected too much of me," according to Navajo belief, one is not to complain. The role of a Navajo woman is to help others, particularly family members. Hobson (1954) confirmed this value of helping the individual physically and not from a psychosocial framework. In reply to the question "I usually feel as if my family is pushing me," the women viewed this as an insult and these feelings are not to be felt and never discussed with anyone. Talking about the family is considered inappropriate to Navajo women (Kluckhohn, 1964). One would be viewed as a complainer if one perceived that "it's pretty tough to be me." The women felt that asking the question as worded in the SEI was an insult. If one has a "low opinion of myself," this is not discussed since feelings are kept "inside" and are not shared with others. This supports Kluckhohn's (1964) study when he viewed the Navajo people as stoic, inward, and not sharing of their inner thoughts and feelings. The concept of "pretty" or "nice looking" is not appropriate to ask a Navajo woman since this would allow her to focus on herself, which is against her cultural beliefs and shows conceit. The focus is on others
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and helping others and not on oneself. The Navajo people have long, beautiful black hair. Turquoise jewelry adorns fingers, hands, arms, head, neck, and waist, and they take pride in selecting a Navajo Queen each year. However, one is not allowed to claim that he or she is better looking than someone else. Gossip is not allowed in the culture and by asking the question "most people are better liked than I am," this would occur. It is considered "not nice" to gossip about others. This finding supports Lamphere's work (1977) with Navajos and the concept of gossiping. DISCUSSION The Navajo and white cultures view the concept of self-esteem in two distinct, yet similar ways, and it is through research that we begin to understand the concept of self-esteem from a Navajo woman's view of life and self. Seven questions were considered personal or offensive by Navajo women. Six of the questions are worded negatively, "expects too much," "pretty tough," "low opinion," "not nice looking," "most people better liked," "pushing me." These negative questions are contradictory to the Navajo belief system of harmony and sense of balance between the self and environment. In the Navajo culture, the self is constantly striving for harmony (Dutton, 1983) and is viewed in a positive dimension. The family remains the basic unit of the Navajo society and the woman holds the family together (Clark, 1978). The three questions concerning the family were reported as personal and information about the family is not discussed with others. One should never complain, gossip, think negative feelings, or discuss family issues. The self of a woman is defined within her family and from a matrilineal kinship structure. Based on this study, concerns exist about the use of the SEI or any self-esteem measure with Navajo women. The study supports the position that cultural values may influence both the way in which Navajo women respond to a self-esteem measure and the actual meaning of selfesteem within their culture. Traditional beliefs stress the acceptance of natural events and the rejection of others' control. Living as one in harmony with nature, family, and others is emphasized (Chisholm, 1983). These values tend to produce nonintrusive, accepting behavior among Navajo women. Such behavior stands in contrast to the competitive, need-to-excel style that characterizes much of the behavior of white, middle-class Americans (Long, 1983). In using the SEI with Navajo women, several conceptual issues arose. The culture tends to disapprove of positive statements about the self and
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to encourage avoidance of any activities that cause one to stand out from, or excel beyond, one's peer group. Pearlin & Schooler (1978) support this position by noting that the Navajos perceive themselves as "one," and even in times of crisis react as a group, emphasizing response to the needs of the tribe rather than the needs of a specific individual or family. Previous research (Arms, 1985), though not focused specifically on self-esteem, found differences in several personality traits when the results from Indian women were contrasted with those from white or black American women. Thus, findings related to the use of established self-esteem measures with Native American women should be interpreted with caution. In general, the SEI appears to be an internally consistent measure of self-esteem. Some interesting questions may be raised, however, with regard to the scale's interpretation when used with Navajo women. Caplin (1969) demonstrated that self-esteem may be closely tied to many of the demographic variables manifested by the Navajo women in this study, such as age, education, and income. From this research, the authors documented that the SEI as presently structured should be used with caution with Navajo women. Revision of the SEI is needed if researchers plan to use this instrument with other cultural groups besides Anglos. Other instruments that measure selfesteem, such as the Rosenberg Self-Esteem Scale and the Tennessee Self-Concept Scale, need to be tested with other cultures for acceptability and applicability. Further research is needed to determine if selfesteem questions reflect content validity when used with Native Americans. Studies need to address Indian groups throughout North America and to consider results from the SEI as well as other psychometrically sound self-esteem measures. In addition, the differential effects of social environment and ethnic culture on self-esteem need to be examined. The SEI does appear to have some measurement error when used with this sample of Navajo women. Piers (1984) claims that ethnicity alone does not seem to have a major effect on self-esteem scores. Ethnicity, however, implies both a culturally determined set of beliefs about oneself and a social milieu in which there is response to one's ethnicity. Health care providers need to understand each of these aspects in order to achieve an accurate and relevant measure of self-esteem in Native Americans.
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Patten, M. A. (1981). Self-concept and self-esteem: Factors in adolescent pregnancy. Adolescence, 16(64), 765-778. Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21. Piers, E. V. (1984). Piers-Harris Children's Self-Esteem Scale (Revised Manual), Los Angeles: Western Psychological Services. Robinson, J. P., & Shaver, P. R. (1973). Measures of social psychological attitudes. Ann Arbor: Institute for Social Research, University of Michigan. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press. Stanwyck, D. J. (1983). Self-esteem through the life span. Family and Community
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