Effective and culturally competent health care requires adequate assessment and measurement tools. Research focused on the Vietnamese population in this area is just beginning. Current research shows that issues arise when using assessment tools to diagnose cognitive impairments in Vietnamese older adults because most tools are in written format, and not all Vietnamese older adults are able to read or comprehend the written tools. Assessment tests are insufficiently adjusted to the patients’ education levels (Yeo et al. 2006) thus there may be under- or over-diagnosis of cognitive impairments in Vietnamese older adults.
Currently there are two well- established and validated instruments for depression for the Vietnamese population: Vietnamese Depression Scale (Buchwald, Manson, Dinges, Keane, & Kinzie, 1993; Kinzie et al, 1982) and the Hopkins Symptom Checklist (Mollica, Wyshak, Marneffe, Khuon, & Lavelle, 1987). Both of these instruments appear to accurately identify Vietnamese with clinical depression at established cut-offs with high sensitivity and specificity (Hinton et al, 1994), although neither instrument has been validated in Vietnamese older adults.
A scale that effectively evaluates the neuropsychological and cognitive state of older adults is the Cross-cultural Neuropsychological Test Battery (CCNB). Linguistic and cultural aspects were considered in developing this scale to make it an effective tool (Dick et al. 2002). In order for the CCNB to be applicable cross-culturally, Dick and colleagues placed emphasis on:
- minimizing testing time;
- incorporating 5 well established measures to easily compare the English and non-English speaking groups;
- using oral or pictorial information to reduce the disparities concerning education levels
- including tests appropriate for varying stages of dementia;
- administering the test by a bilingual staff.