Cultural competency and microaggressions in the provision of care to LGBT patients in rural and appalachian Tennessee

Patterson, Joanne G.; Jabson, Jennifer M.; Kamen, Charles

doi:10.1016/j.pec.2019.06.003

Cited by 51 publications

(44 citation statements)

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“…Our results point to several areas for intervention: First, screening for sexual orientation in the cancer setting is critical for identifying LBW who may be at risk for poor health during treatment and survivorship. Unfortunately, physicians do not regularly ask about sexual orientation, 79 and LGB people report feeling unwelcome when accessing health care. 80 Routine assessment of sexual orientation may strengthen the patient-clinician relationship, create a safe environment for health care discussions, and foster healthy behaviors.…”

Section: Future Directionsmentioning

confidence: 99%

“…81,82 Inclusive intake forms help standardize sexual orientation and gender identity assessment. 83 Because a majority of oncologists do not feel competent to treat LGBT patients 79,84,85 and sexual minority patients who do not have an LGBTcompetent oncologist report higher rates of stress, 86 we recommend that oncology practices implement mandatory training in LGBT competence. Health care providers may review national guidelines to learn about caring for sexual minority individuals with cancer.…”

Section: Future Directionsmentioning

confidence: 99%

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Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

et al. 2021

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Purpose: Health-related quality of life (HRQoL) and health behaviors contribute to cancer morbidity and mortality, which are elevated in lesbian and bisexual women (LBW). The purpose of this study was to assess differences in HRQoL and health behaviors between heterosexual and lesbian women and heterosexual and bisexual women cancer survivors. Methods: We pooled 2013-2018 National Health Interview Survey data. HRQoL comprised physical, mental, financial, and social health domains. Health behaviors included tobacco and alcohol use, physical activity, and preventive health care. Weighted, multivariable logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 10,830 heterosexual, 141 lesbian, and 95 bisexual cancer survivors. Lesbian women reported higher odds of fair/poor self-rated health (

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Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

et al. 2021

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“…These behaviours contribute to marginalization and social exclusion, further compounding their poor mental health (Eady et al, 2011; Kidd et al, 2016; Ross et al, 2010). Arising from this is the need for mental health practitioners to examine their own attitudes, values and beliefs, within the wider context of culturally competent health care (Handtke et al, 2019; Patterson et al, 2019; Saliba et al, 2019). From a mental health practice perspective, it is important that practitioners do not dismiss or ignore the disclosure of a bisexual identity.…”

Section: Discussionmentioning

confidence: 99%

The views and experiences of bisexual people regarding their psychosocial support needs: a qualitative evidence synthesis

McCann

Brown

Taylor

2020

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Bisexual people experience significantly poorer mental health and higher rates of self‐harm and suicidality than their gay, lesbian or heterosexual counterparts. Although little is understood about why these disparities exist, bisexual people have been found to have unique life experiences that separate them from other sexual minority groups. Despite these health disparities and unique experiences, in research and in clinical settings, bisexual people are often incorporated under the LGBTQI+ umbrella and their needs are not seen as being different to those of other sub‐groups. What the paper adds to existing knowledge? This paper brings together the findings of the small but growing body of literature reporting on the psychosocial support needs of bisexual people. The findings reported on herein provide novel insights, collated and synthesized that will prove valuable to policy makers, service providers and researchers. What are the implications for practice? This paper clearly illustrates that bisexual people experience significant barriers to accessing the support services they need and that current competent service provision for this population is severely limited. The findings presented in this paper shed light on the unique psychosocial needs of bisexual people and highlight the need for practice change to reduce barriers to service access and ensure inclusive and culturally competent care for this community. Abstract IntroductionDespite consistent evidence of poor mental health among what is a relatively large population group, research examining bisexual mental health remains sparse. AimTo identify the psychosocial needs of people who are bisexual and establish factors that may support or inhibit access to appropriate psychosocial interventions and supports. MethodA qualitative evidence syntheses of the empirical evidence. ResultsA total of 15 papers were included in the review. The PRISMA process was used. Following data analysis, four main themes emerged that were (a) experiences of being bisexual, (b) mental health experiences and concerns, (c) service access and responses and (iv) communities and supports. DiscussionBisexual people have unique and specific psychosocial support needs that relate to, but are also different from, the needs of the broader LGBTIQ+ community. This study provides valuable insights into how future policy, practice, education and training and research can better address the needs of this highly vulnerable group. Implications for PracticeThis study highlights the psychosocial complexities associated with bisexuality and provides evidence for the need for improvement in current support services to ensure inclusivity and culturally competent care.

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“…Transgender patients may avoid seeking medical care due to a history of traumatizing interactions with healthcare providers [6] and the inability to locate affirming providers. Transgender people also report abuse and discrimination from healthcare workers in response to their nontraditional gender identities and sexual preferences [6][7][8]. The development of healthcare systems serving transgender people is considered a "wicked problem", i.e., one that is systematic, complex, and persistent [9].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Use of the Consolidated Framework for Implementation Research to Evaluate the Creation of a Rural Center of Excellence in Transgender Health

Tinc

Wolf-Gould

et al. 2020

IJERPH

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Background: Transgender people face numerous barriers to accessing care, particularly in rural settings. Transportation, travel time, a lack of providers offering transgender care, and discrimination all contribute to these barriers. The Gender Wellness Center was established in New York State, USA, to fill a gap in rural transgender care and was subsequently awarded a Robert Wood Johnson Foundation grant to establish a Center of Excellence. This study examined the implementation of the Center of Excellence, a complex intervention, to assess barriers and facilitators to implementation over 18 months. Methods: The Consolidated Framework for Implementation Research (CFIR) was used to develop baseline and follow-up surveys. These were distributed to members of the core implementation team at the Gender Wellness Center at the midpoint and conclusion of the Robert Wood Johnson Foundation grant. Responses were largely open-ended and analyzed qualitatively. Results: Results are presented in terms of CFIR domains and constructs, as well as the relative outlook (positive or negative) of implementation. Overall, there were improvements over time, with more encouraging feedback and examples of success at follow-up. Though true, organizational culture and individual beliefs about the provision of transgender care challenged implementation of the Center of Excellence throughout the project. Conclusions: This study highlights the importance of organizational culture on implementation efforts, as well as the need for complex, multifaceted interventions to overcome such challenges in order to improve care for marginalized populations.

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Cultural competency and microaggressions in the provision of care to LGBT patients in rural and appalachian Tennessee

Cited by 51 publications

References 50 publications

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey

The views and experiences of bisexual people regarding their psychosocial support needs: a qualitative evidence synthesis

Longitudinal Use of the Consolidated Framework for Implementation Research to Evaluate the Creation of a Rural Center of Excellence in Transgender Health

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