Hardacker Cecilia T, Rubinstein Betsy, Hotton Anna, Houlberg Magda
Geriatric Education, Howard Brown Health Center, Chicago, IL, USA.
J Nurs Manag. 2014 Mar;22(2):257-66. doi: 10.1111/jonm.12125. Epub 2013 Jul 22.
In 2009, the Howard Brown Health Center received funding from the US Department of Health and Human Services, and Health Resources and Services Administration to develop and disseminate a peer-reviewed, six-module curriculum entitled, Health Education about LGBT (lesbian, gay, bisexual and transgender) Elders (HEALE).
The HEALE curriculum targets nurses and health-care staff and is focused on the treatment of LGBT elders, a population that is largely misunderstood and discriminated against in health-care settings. The HEALE curriculum was presented in hospital academic centres, community-based clinics and nursing homes over a three-year period, and training staff provided education to over 500 nurses and health-care providers.
A pre-test and post-test was administered to participants, and all data were collected and archived to measure knowledge gained. Participants also completed an evaluation at the conclusion of the training to report change in personal attitude and individual response to the curriculum.
From March 2011 to June 2012, 848 individuals attended HEALE curriculum sessions at 23 locations in Chicago and surrounding areas. Participants were 40% white, 25% black, 9% Hispanic/Latino and 25% Asian race/ethnicity. The majority of participants were female and approximately 25% were under the age of 30 years. There were statistically significant gains in knowledge in each of the six modules both in nursing home/home health-care settings and in hospital/educational settings, although participants in nursing home/home health care settings had lower pre-test scores and smaller knowledge gains in each of the six modules than those in hospital/educational settings. Mean increases ranged from 6.4 points (an 8.7% increase) in module 1-14.6 points (a 26.2% increase) in Module 6 (P < 0.01).
The HEALE curriculum sets a standard for best practices in nursing management and for LGBT cultural competency in geriatric education. As such, implementation of this cultural competency training will go a long way to establish fundamental concepts regarding LGBT elder care and provide long-term strategies for providing culturally sensitive patient care.
2009年，霍华德·布朗健康中心获得了美国卫生与公众服务部以及卫生资源与服务管理局的资助，用于开发并推广一门经过同行评审的、共六个模块的课程，名为“LGBT（女同性恋、男同性恋、双性恋和跨性别者）老年人健康教育（HEALE）”。
HEALE课程的目标受众是护士和医护人员，重点在于LGBT老年人的治疗，这一群体在医疗环境中很大程度上被误解和歧视。HEALE课程在三年时间内在医院学术中心、社区诊所和疗养院进行讲授，培训人员为500多名护士和医疗服务提供者提供了教育。
对参与者进行了课前测试和课后测试，并收集和存档所有数据以衡量所获得的知识。参与者还在培训结束时完成了一项评估，以报告个人态度的变化以及对课程的个人反应。
2011年3月至2012年6月，848人参加了在芝加哥及其周边地区23个地点举办的HEALE课程。参与者中40%为白人，25%为黑人，9%为西班牙裔/拉丁裔，25%为亚裔。大多数参与者为女性，约25%年龄在30岁以下。在疗养院/家庭医疗环境和医院/教育环境中，六个模块中的每一个模块的知识都有统计学上的显著提高，尽管疗养院/家庭医疗环境中的参与者课前测试分数较低，且六个模块中的每一个模块的知识增长幅度都小于医院/教育环境中的参与者。平均增长幅度从模块1的6.4分（增长8.7%）到模块6的14.6分（增长26.2%）（P<0.01）。
HEALE课程为护理管理的最佳实践以及老年教育中的LGBT文化能力设定了标准。因此，实施这种文化能力培训将大大有助于确立有关LGBT老年人护理的基本概念，并为提供具有文化敏感性的患者护理提供长期策略。
