Ruben Mollie A, Shipherd Jillian C, Topor David, AhnAllen Christopher G, Sloan Colleen A, Walton Heather M, Matza Alexis R, Trezza Glenn R
a Department of Humanities, Behavioral, and Social Sciences, School of Arts and Sciences , Massachusetts College of Pharmacy and Health Sciences (MCPHS) University , Boston , Massachusetts , USA.
b Section of General Internal Medicine, Boston University School of Medicine , Boston , Massachusetts , USA.
J Homosex. 2017;64(10):1411-1431. doi: 10.1080/00918369.2017.1321386.
Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.
具有文化胜任力的医疗保健对于性取向和性别少数群体患者尤为重要，因为文化胜任力不足会导致健康差距。尤其需要了解如何改善针对女同性恋、男同性恋、双性恋和跨性别（LGBT）退伍军人的医疗保健质量和服务，因为他们作为LGBT群体成员和退伍军人有着独特的身心健康需求。以下文章是一个案例研究，重点关注与LGBT临床胜任力、专业培训以及为波士顿退伍军人医疗管理局（VA）医疗系统中的退伍军人患者提供符合伦理的医疗服务相关的政策和临床护理实践。我们应用贝当古等人（2003年）的文化胜任力框架来概述波士顿退伍军人医疗管理局医疗系统在组织、结构和临床层面提高文化胜任力所采取的步骤。通过分享我们的经验，我们旨在为其他有兴趣开展LGBT健康倡议的医疗保健系统和项目提供一个模式和步骤，这些系统和项目包括其他退伍军人医疗管理局医疗系统、大型学术医疗保健系统、社区医疗保健系统和心理健康保健系统。
