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医学生对其学习环境中女同性恋、男同性恋、双性恋和跨性别者(LGBT)歧视的认知以及他们自我报告的照顾LGBT患者的舒适程度:一项调查研究。

Medical students' perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study.

作者信息

Nama Nassr, MacPherson Paul, Sampson Margaret, McMillan Hugh J

机构信息

a Department of Pediatrics , University of British Columbia , Vancouver , Canada.

b Faculty of Medicine , University of Ottawa , Ottawa , Canada.

出版信息

Med Educ Online. 2017;22(1):1368850. doi: 10.1080/10872981.2017.1368850.

Abstract

BACKGROUND

Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare.

OBJECTIVE

The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients.

DESIGN

Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey.

RESULTS

Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%).

CONCLUSION

Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

摘要

背景

从历史上看,女同性恋、男同性恋、双性恋或跨性别(LGBT)医学生报告的社会压力、抑郁和焦虑发生率更高,而LGBT患者则报告遭受了歧视且获得医疗保健的机会更少。

目的

本研究的目的是:(1)评估医学生在学习环境中是否察觉到歧视;(2)确定自我报告的照顾LGBT患者的舒适度。

设计

通过电子邮件联系渥太华大学的医学生(N = 671),邀请他们完成一项基于网络的保密调查。

结果

回复率为15.4%(103/671)。其中包括66名顺性别异性恋者(64.1%)和37名LGBT学生(35.9%)。14.6%的受访者目睹过反LGBT歧视,31.1%的受访者目睹过异性恋主义。反LGBT歧视最常源于医学生同学。自我认同为LGBT的受访者更有可能察觉到异性恋主义(偏爱异性关系)(优势比=8.2,p<0.001)或反LGBT歧视(优势比=6.6,p = 0.002)。虽然一半的LGBT学生与所有同学分享了他们的身份(51.4%),但他们更有可能向 staff physicians隐瞒这一身份(优势比=27.2,p = 0.002)。近一半的医学生(41.7%)报告称,医学生同学和/或医疗团队的其他成员开过反LGBT的玩笑、传播过谣言和/或进行过欺凌。尽管如此,大多数受访者表示,他们对为LGBT患者提供医疗护理感到自在且有能力这样做(≥83.5%),并且对围绕LGBT健康问题的进一步教育感兴趣(84.5%)。

结论

医学生注意到了反LGBT歧视和异性恋主义,这表明LGBT学生的学习环境不理想。尽管如此,学生们报告称在为LGBT患者提供医疗保健方面有很高的舒适度和信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ad/5653936/fb5a1dc27146/ZMEO_A_1368850_F0001_B.jpg

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