Program for the Study of LGBT Health, Columbia University School of Nursing, New York, New York.
Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York.
Gerontologist. 2020 Apr 2;60(3):e169-e183. doi: 10.1093/geront/gnz012.
Discrimination toward the lesbian, gay, bisexual and transgender (LGBT) population has raised concerns about the type of long-term services and supports (LTSS) that will be available to them as they age. To understand the unique needs of aging LGBT populations, we sought to synthesize and critique the evidence related to LTSS providers and LGBT individuals' perspectives of LGBT issues in LTSS in the United States.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review of the literature was conducted. The Crowe Critical Appraisal Tool was used to appraise the quality of the included studies.
Nineteen studies met inclusion criteria. Seven studies that examined the perspectives of LTSS providers identified two themes, including that they lack knowledge and training on LGBT health issues and generally report negative attitudes toward same-sex relations among older adults. In addition, 12 studies that examined the perspectives of LGBT individuals found that they (i) are concerned about LTSS planning, (ii) fear discrimination from providers in LTSS, and (iii) identify several strategies for improving care of LGBT older adults receiving LTSS.
This systematic review highlights the importance for LTSS providers to receive training in LGBT health and be reflective of potential biases toward the LGBT population. LGBT individuals identified concerns related to LTSS planning and fear of discrimination from LTSS providers. LGBT individuals also identified a need for increased training of providers to improve the care of LGBT older adults in LTSS.
对女同性恋、男同性恋、双性恋和跨性别（LGBT）人群的歧视引起了人们对他们随着年龄增长可获得的长期服务和支持（LTSS）类型的关注。为了了解老龄化 LGBT 人群的独特需求，我们试图综合和评估美国 LTSS 中与 LTSS 提供者以及 LGBT 个体对 LGBT 问题的看法相关的证据。
根据系统评价和荟萃分析的首选报告项目，对文献进行了系统综述。使用 Crowe 批判性评估工具对纳入研究的质量进行了评估。
有 19 项研究符合纳入标准。有 7 项研究考察了 LTSS 提供者的观点，确定了两个主题，包括他们缺乏关于 LGBT 健康问题的知识和培训，并且通常对老年人的同性关系持负面态度。此外，有 12 项研究考察了 LGBT 个体的观点，发现他们（i）担心 LTSS 规划，（ii）担心在 LTSS 中受到提供者的歧视，（iii）确定了一些改善接受 LTSS 的 LGBT 老年个体护理的策略。
这项系统综述强调了 LTSS 提供者接受 LGBT 健康培训以及反思对 LGBT 人群潜在偏见的重要性。LGBT 个体确定了与 LTSS 规划相关的担忧以及对 LTSS 提供者歧视的恐惧。LGBT 个体还确定了需要增加提供者的培训，以改善接受 LTSS 的 LGBT 老年个体的护理。
