Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.
The purpose of this study is to describe the meaning of being a perioperative nurse within the contexts of the sociopolitical, economic, and cultural forces that influence perioperative nursing practice. A theory of communicative action provided the framework for this philosophical inquiry. The researcher conducted one‐time, in‐depth interviews with six expert perioperative nurses selected from three practice settings in the northeastern United States. These interviews resulted in the text that the researcher analyzed based on the principles of critical hermeneutics, and four constitutive patterns were identified. The meaning of being a perioperative nurse for these nurses was identified as a struggle to make sense of their existence in the OR. AORN J 74 (Aug 2001) 202–217.
Patient safety in the OR depends on effective communication. We developed and tested a communication training program for surgical oncology staff members to increase communication about patient safety concerns. In phase one, 34 staff members participated in focus groups to identify and rank factors that affect speaking up behavior. We compiled ranked items into thematic categories that included role relations and hierarchy, staff rapport, perceived competence, perceived efficacy in speaking up, staff personality, fear of retaliation, institutional regulations, and time pressure. We then developed a communication training program that 42 participants completed during phase two. Participants offered favorable ratings of the usefulness and perceived effect of the training. Participants reported significant improvement in communicating patient safety concerns (t40 = −2.76, P = 0.009, d = 0.48). Findings offer insight into communication challenges experienced by surgical oncology staff members and suggest that our training demonstrates the potential to improve team communication.
Critical social theory, including the work of Jürgen Habermas, provides a valuable lens for viewing phenomena within their sociopolitical contexts. According to Habermas, the lives and experiences of individuals, groups, and societies in the western world are strongly influenced by the forces of economics and power. These influences may interfere with communication and, therefore, the transmission and regeneration of culture and its meaning. This article describes the experience of initiating an international exchange program at a university school of nursing in the eastern United States. Examined through the lens of Habermas' theory, constraints and obstacles encountered in this process are revealed. Specifically, the inhibiting influence that politics and economics may have on active communication and the potential benefits of shared meaning and understanding achieved by interaction and discourse are examined.
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