Eating disorders (EDs) are often stereotyped as affecting the SWAG, that is, as affecting mostly skinny, White, affluent girls. Over the last decade, however, significant progress has been made toward increasing diversity in ED research. There is consensus that EDs affect individuals of all genders, ages, sexual orientations, ethnic, and socio-economic backgrounds, with recent studies exploring social determinants of ED etiology, ED presentation, and developing diversity-affirming ED assessments. This article provides a brief summary of current developments related to diversity as a research theme, and proposes different perspectives toward further improving diversity in ED research. Specifically, we argue for exploring the role of diversity in ED treatment settings and outcomes, for pursuing diversity-oriented research pro-actively rather than as a reaction to issues of under-representation, and for integrating diversity across different areas of medical education and trainings in psychotherapy. Limitations with respect to the paucity of research, and the link between diversity as a research theme and ED-related workforce diversity are discussed.
Zusammenfassung Zielsetzung Lesbische, schwule, bisexuelle, trans, intergeschlechtliche und queere (LSBTIQ+) Personen erfahren auch heutzutage Diskriminierung und Benachteiligung in vielen Lebensbereichen – auch im Bereich der Gesundheitsversorgung. Studien weisen darauf hin, dass LSBTIQ+Personen einerseits hohe Raten an chronischen körperlichen und psychischen Erkrankungen zeigen, andererseits über negative Erfahrungen mit Behandler_Innen im Gesundheitssystem berichten. Das Ziel dieser Arbeit ist es, einerseits auf Barrieren und eine unzureichende gesundheitliche Versorgung von LSBTIQ+Personen hinzuweisen, andererseits aber auch, auf relevante Lücken in der medizinischen Ausbildung in Deutschland aufmerksam zu machen, woraufhin spezifische Aktionen folgen sollen. Methodik Zu diesen Zwecken werden sowohl wissenschaftliche Evidenz für die Benachteiligung von LSBTIQ+Personen im Gesundheitssystem als auch wichtige innovative Interventionen in der Ausbildung von medizinischem Personal vorgestellt und diskutiert. Ergebnisse Eine Vielzahl von unterschiedlichen – in Bezug auf Umfang, Format und Inhalten – Ausbildungsprogrammen sind bereits erprobt und etabliert, allerdings vor allem in englischsprachigen Regionen der Welt. In der medizinischen Ausbildung in Deutschland fehlen dagegen solche Programme. Schlussfolgerung Eine Sensibilisierung für und Erweiterung der Ausbildung von Medizinstudierenden um LSBTIQ+Gesundheitsthemen ist in Deutschland von großer Bedeutung.
The healthcare needs of lesbian, gay, bisexual, trans*, queer, and intersex (LGBTQI+) persons are often overlooked, prompting national and international calls to include diversity-related competencies into medical students’ training. However, LGBTQI+-focused healthcare education targets remain elusive, as surveys reveal considerable variability across national student populations. To generate empirical data and vocalize recommendations for medical education, we conducted the first nationwide online survey among 670 German medical students from 33 universities. Overall, most respondents reported low confidence regarding their medical training preparing them for LGBTQI+ patients, stated that LGBTQI+ themes were not covered during training, and agreed that the inclusion of such themes is urgently needed. In addition, we found gender and LGBTQI+ community member status to be key variables. Men scored lower in knowledge than women, while community members scored higher than non-community members. Similarly, community members reported higher comfort levels. Non-community men showed the highest levels of prejudice and efficacy beliefs, while at the same time had the lowest scores in contacts and the perceived importance of LGBTQI+-related teaching. Keeping subgroup differences in mind, we recommend that educational training should include LGBTQI+ healthcare aspects and address self-efficacy beliefs in future medical professionals to overcome LGBTQI+ healthcare disparities.
Organ transplantation is associated with significant physical and psychological burden for the recipients. Qualitative reports indicate that organ recipients develop donor and donation images (DDI)—conceptions of the donor and/or the organ. A deeper understanding of DDI is needed in the care of transplant recipients. To present the current state of knowledge, we searched for and identified DDI-related publications in PubMed and Scopus. Inclusion criteria were (1) studies addressing transplant recipients, and (2) English or German language. Twenty-one studies of individuals with transplanted hearts, lungs, or kidneys were included in this scoping review. Prevalence for DDI ranged from 6% to 52.3%. DDI occurs both before and after transplantation and includes ideas about the donor as well as whether and how the recipient’s personality may be altered by the transplanted organ. Some transplant recipients did indeed report personality changes following transplantation due to the adoption of assumed donor characteristics. One study showed a positive association between the presence of DDI and anxiety scores and one described a coping effect. DDI is understudied and should be systematically assessed to improve care for the vulnerable group of individuals undergoing organ transplantation. Current research gaps and future directions are discussed.
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