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张开双臂,内心矛盾:执业护士对与女同性恋、男同性恋和双性恋患者合作的态度。

Open arms, conflicted hearts: nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients.

作者信息

Dorsen Caroline, Van Devanter Nancy

机构信息

NYU Meyers College of Nursing, New York, NY, USA.

出版信息

J Clin Nurs. 2016 Dec;25(23-24):3716-3727. doi: 10.1111/jocn.13464.

Abstract

AIMS AND OBJECTIVES

To explore nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients.

BACKGROUND

Literature suggests that lesbians, gay men and bisexuals have significant health disparities compared to heterosexuals. Although the reasons are multifactorial, research suggests that attitudes of healthcare providers (HCPs) may be a contributing factor in both accessing and receiving care. There is currently no literature exploring the attitudes of the approximately 300,000 nurse-practitioners in the United States. Thus, nurse-practitioners strengths and challenges in providing care to sexual minorities are unknown.

DESIGN

As part of a larger study, Corbin & Strauss' grounded theory methodology was used to explore the attitudes towards lesbian, gay and bisexual patients among primary care nurse-practitioners in NYC.

METHODS

Data were collected via individual semi-structured interviews with nurse-practitioners currently in practice in primary or outpatient care in NYC (n = 19). Data were evaluated using the three-step constant comparison method.

RESULTS

Nurse-practitioners in this study had varied, often overlapping and sometimes conflicting, attitudes about working with lesbian, gay and bisexual patients. The main theme identified was 'open arms, conflicted hearts' with three major subthemes - feeling at home, struggling to maintain professionalism and finding comfort under the umbrella of diversity.

CONCLUSIONS

Nurse-practitioner participants in this study had varied attitudes about working with lesbian, gay and bisexual patients, ranging from open, confident and comfortable to ambivalent, cautious and unsure about working with lesbian, gay and bisexual patients generally and specifically regarding the health needs of this population.

RELEVANCE TO CLINICAL PRACTICE

This study highlights the inadequate didactic and clinical preparation most nurse-practitioners feel they have to care for lesbian, gay and bisexual patients. There is a need for increased education for registered nurses and nurse-practitioners regarding lesbian, gay and bisexual culture, their unique healthcare needs, as well as the role of stigma and marginalisation in caring for vulnerable populations.

摘要

目的与目标

探讨执业护士对与女同性恋、男同性恋和双性恋患者合作的态度。

背景

文献表明,与异性恋者相比,女同性恋者、男同性恋者和双性恋者存在显著的健康差异。尽管原因是多方面的,但研究表明,医疗服务提供者(HCPs)的态度可能是获得和接受护理的一个促成因素。目前尚无文献探讨美国约30万名执业护士的态度。因此,执业护士在为性少数群体提供护理方面的优势和挑战尚不清楚。

设计

作为一项更大规模研究的一部分,采用Corbin & Strauss的扎根理论方法,探讨纽约市初级护理执业护士对女同性恋、男同性恋和双性恋患者的态度。

方法

通过对纽约市目前从事初级或门诊护理工作的执业护士进行个人半结构化访谈收集数据(n = 19)。使用三步持续比较法对数据进行评估。

结果

本研究中的执业护士对与女同性恋、男同性恋和双性恋患者合作的态度各不相同,常常相互重叠,有时相互冲突。确定的主要主题是“张开双臂,内心矛盾”,有三个主要子主题——感觉自在、努力保持专业精神以及在多样性的保护伞下找到慰藉。

结论

本研究中的执业护士参与者对与女同性恋、男同性恋和双性恋患者合作的态度各不相同,从开放、自信和自在到矛盾、谨慎以及对一般情况下与女同性恋、男同性恋和双性恋患者合作,特别是对该人群的健康需求感到不确定。

与临床实践的相关性

本研究强调了大多数执业护士认为他们在护理女同性恋、男同性恋和双性恋患者方面缺乏足够的教学和临床准备。需要加强对注册护士和执业护士关于女同性恋、男同性恋和双性恋文化、他们独特的医疗保健需求以及耻辱和边缘化在照顾弱势群体中的作用的教育。

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