Moll Joel, Krieger Paul, Heron Sheryl L, Joyce Cara, Moreno-Walton Lisa
Department of Emergency Medicine Virginia Commonwealth University School of Medicine Richmond VA.
Department of Emergency Medicine Mount Sinai Beth Israel Medical Center New York NY.
AEM Educ Train. 2019 Jan 21;3(2):129-135. doi: 10.1002/aet2.10318. eCollection 2019 Apr.
Although lesbian, gay, bisexual, and transgender (LGBT) patients are ubiquitous in emergency medicine (EM), little education is provided to EM physicians on LGBT health care needs and disparities. There is also limited information on EM physician behavior, comfort, and attitudes toward LGBT patients. The objective of this study was to assess EM residents behavior, comfort, and attitudes in LGBT health.
An anonymous survey link was sent to EM programs via the Council of Residency Director listserv. The primary outcome of the 24-item descriptive survey was the self-reported comfort levels and self-reported practice in LGBT health care. Secondary outcomes included individual comfort toward LGBT colleagues and patients who are LGBT, and the frequency of colleagues making discriminatory statements toward LGBT patients and staff in the emergency department setting. Associations between personal and program demographics and survey responses were also examined.
There were 319 responses The majority of respondents were male (63.4%), Caucasian (69.1%), and heterosexual (92.4%). A sizeable minority of respondents felt histories and physical examinations were more challenging for lesbian, gay, or bisexual patients (24.6%) and more so for transgender patients (42.6%). Most residents do not ask patients to identify sexual orientation when presenting with abdominal or genital complaints (63%). Discriminatory LGBT comments were reported from both fellow residents (16.6%) and faculty (10%). A total of 2.5% of respondents were uncomfortable with other LGBT physicians, and 6% did not agree that LGBT patients deserve the same quality care as others.
A number of residents find caring for LGBT patients more challenging than heterosexual patients. Even with professed comfort with LGBT health care, most residents report taking incomplete sexual histories that may affect patient care. Attitudes toward LGBT patients are mainly, but not completely, positive in this cohort.
尽管女同性恋、男同性恋、双性恋和跨性别（LGBT）患者在急诊医学（EM）中很常见，但针对急诊医学医生提供的关于LGBT医疗保健需求和差异的教育却很少。关于急诊医学医生对LGBT患者的行为、舒适度和态度的信息也很有限。本研究的目的是评估急诊医学住院医师在LGBT健康方面的行为、舒适度和态度。
通过住院医师主任委员会的邮件列表向急诊医学项目发送了一个匿名调查链接。这项包含24个条目的描述性调查的主要结果是自我报告的在LGBT医疗保健方面的舒适度和实践情况。次要结果包括对LGBT同事以及LGBT患者的个人舒适度，以及同事在急诊科环境中对LGBT患者和工作人员发表歧视性言论的频率。还研究了个人和项目人口统计学与调查回复之间的关联。
共收到319份回复。大多数受访者为男性（63.4%）、白种人（69.1%）和异性恋（92.4%）。相当一部分受访者认为，对于女同性恋、男同性恋或双性恋患者，病史和体格检查更具挑战性（24.6%），而对于跨性别患者则更是如此（42.6%）。大多数住院医师在患者出现腹部或生殖器不适时不会询问其性取向（63%）。住院医师同伴（16.6%）和教员（10%）都有报告过歧视性LGBT言论。共有2.5%的受访者对其他LGBT医生感到不舒服，6%的受访者不同意LGBT患者应得到与其他人相同质量的护理。
许多住院医师发现照顾LGBT患者比照顾异性恋患者更具挑战性。即使自称对LGBT医疗保健感到自在，大多数住院医师报告称获取的性病史不完整，这可能会影响患者护理。在这个队列中，对LGBT患者的态度主要是积极的，但并不完全如此。
