Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: A systematic review and meta‐synthesis

Lisy, Karolina; Peters, Micah D J; Schofield, Penelope; Jefford, Michael

doi:10.1002/pon.4674

Cited by 103 publications

(106 citation statements)

References 45 publications

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“…Our findings that the presence of a partner can act as a prompt to sexual orientation disclosure to a professional confirms other findings in the literature [36] and can thus promote self-actualisation and authenticity. But the distinctive contribution of the findings lies in participants’ recognition that validation of their relationship helps them to feel at ease and accepted.…”

Section: Discussionsupporting

confidence: 91%

Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment

2019

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Background The literature on sexual orientation disclosure is arguably one of the most developed in the field of lesbian, gay and bisexual (LGB) people in healthcare in English speaking countries however, relatively little research has been conducted into disclosure in cancer care. Studies have been mainly undertaken in primary care where distinct circumstances pertain and where the benefits of disclosure include obtaining appropriate health information, treatment advice and avoiding misdiagnosis. Methods We conducted an in-depth qualitative study primarily recruiting patients through oncology care in hospital settings and through LGB community cancer support groups. Data were gathered through semi-structured interviews with 30 LGB patients with different cancer types. Results Data were analysed using thematic analysis and interpreted and interrogated through salutogenesis theory which offers a useful lens through which to consider the health promoting effects of sexual orientation disclosure in cancer care. We present three themes as part of the analysis: Authenticity as a driver for disclosure in cancer care, Partners as a (potential) salutogenic resource and Creating safe, healing environments conducive to disclosure. The findings are reported and discussed in relation to three inter-related concepts from current salutogenesis theorising including a sense of coherence, generalised resistance resources and healing environments which can facilitate sexual orientation disclosure. Conclusion Our findings enable a more nuanced approach to understanding disclosure in this context. This study contributes to the literature through its articulation of the salutogenic potential of disclosure (if responded to appropriately) for LGB patients as individuals, in relationship to their partners or carers and the role of creating a visible healing-oriented optimal environment to promote quality of life and recovery. Electronic supplementary material The online version of this article (10.1186/s12885-019-5895-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment

2019

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“…The lesbian, gay, bisexual, transgender, and queer/ questioning (LGBTQ) community, also referred to as sexual and gender minorities (SGMs), 1 is a diverse and medically underserved population [2][3][4][5] that is often marginalized in a predominantly hetero-and cisgendernormative society. Despite the overwhelming evidence of cancer disparities related to age, sex, race/ethnicity, income, social class, disability, and geographic location, 6,7 there have been limited efforts to address cancer disparities by sexual orientation and gender identity (SOGI).…”

Section: Introductionmentioning

confidence: 99%

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

Schabath

Blackburn

Sutter

et al. 2019

JCO

115

124

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PURPOSE To identify potential gaps in attitudes, knowledge, and institutional practices toward lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients, a national survey of oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers was conducted to measure these attributes related to LGBTQ patients and desire for future training and education. METHODS A random sample of 450 oncologists from 45 cancer centers was selected from the American Medical Association’s Physician Masterfile to complete a survey measuring attitudes and knowledge about LGBTQ health and institutional practices. Results were quantified using descriptive and stratified analyses and by a novel attitude summary measure. RESULTS Of the 149 respondents, there was high agreement (65.8%) regarding the importance of knowing the gender identity of patients, which was contrasted by low agreement (39.6%) regarding the importance of knowing sexual orientation. There was high interest in receiving education regarding the unique health needs of LGBTQ patients (70.4%), and knowledge questions yielded high percentages of “neutral” and “do not know or prefer not to answer” responses. After completing the survey, there was a significant decrease ( P < .001) in confidence in knowledge of health needs for LGB (53.1% agreed they were confident during survey assessment v 38.9% postsurvey) and transgender patients (36.9% v 19.5% postsurvey). Stratified analyses revealed some but limited influence on attitudes and knowledge by having LGBTQ friends and/or family members, political affiliation, oncology specialty, years since graduation, and respondents’ region of the country. CONCLUSION This was the first nationwide study, to our knowledge, of oncologists assessing attitudes, knowledge, and institutional practices of LGBTQ patients with cancer. Overall, there was limited knowledge about LGBTQ health and cancer needs but a high interest in receiving education regarding this community.

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“…Schroeder and DiAngelo (2010) point out that the persistent identification of nursing as a 'caring' profession inadvertently creates and maintains the discourse of colour blindness, as it maintains the idea that nurses treat everyone the same and do not oppress. Furthermore, it implies that nurses have evolved past influences of stigmatisation, ignorance and discrimination, a claim that is contradicted by several studies (see, e.g., Ben, Cormack, Harris, & Paradies, 2017;Fiscella & Sanders, 2016;Grant & Guerin, 2018;Lisy, Peters, Schofield, & Jefford, 2018;Nhamo-Murire & Macleod, 2017;Trollor et al, 2016). Norm-critical perspectives in education could add discussions about power and privilege to the seemingly neutral and morally righteous ideal of nursing seen in our analysis, identifying that there are no objective outlooks on caring.…”

Section: Discussionmentioning

confidence: 66%

From political correctness to reflexivity: A norm‐critical perspective on nursing education

et al. 2020

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Education is important in shaping professional identity, including how one approaches norms and normalisation. In the analysis presented in this study, nursing students' own constructions of norms and normality from the outlook of their education are highlighted and problematised. To deepen the understanding of these matters, the aim of this study was to explore constructions of norms and normality among students in nursing education. Students studying in a nursing department at a Swedish university college were approached and asked to consider open survey questions targeting their views on norms and normality; 154 of them replied. After a discourse analytic approach to the data, we could see how the students constructed norms and normality as (a) instrumental instructions, consisting of easy‐to‐digest statements grounded in the profession's obvious moral and ethical values, (b) limiting and frustrating obstacles for personal freedom that were important to challenge, (c) rules to be obeyed for the stability of society and (d) a matter of reflection, with each individual being responsible for understanding differences in norms, perspectives and opinions. We conclude that nursing education would benefit from norm‐critical perspectives, problematising students' own positions to norms, power and privilege.

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Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: A systematic review and meta‐synthesis

Cited by 103 publications

References 45 publications

Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment

Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

From political correctness to reflexivity: A norm‐critical perspective on nursing education

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