Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
Fam Pract. 2024 Aug 14;41(4):579-586. doi: 10.1093/fampra/cmad024.
Rainbow young people (RYP; people of diverse genders, sexualities, and variations in sex characteristics) face barriers accessing primary care, often report negative experiences and the need to educate clinicians on rainbow-specific issues. This study explores general practice staff views and experiences of providing care to RYP.
Three focus groups were held with staff from 5 general practices in an urban area of Aotearoa New Zealand (25 participants in total). Practices were purposively selected to include some known to be more "rainbow-friendly" seeing larger numbers of RYP and some with no particular focus on RYP. All members of each practice were invited to participate, including administration and reception staff. Focus groups were audio-recorded, transcribed, and analysed in NVivo using inductive thematic analysis.
Four main themes were identified: (i) Practice experience, (ii) Feeling awkward, (iii) Knowledge and training, and (iv) Structural barriers. Differences were apparent in health provider knowledge, comfort, and experience in providing care to RYP. Participants identified a lack of knowledge and training and wanted more resources and education. Systems limitations were common (e.g. with IT systems for recording gender) and often contributed to awkward clinical encounters.
Participants recognized shortcomings in their training, knowledge, and level of confidence providing care to RYP and expressed a desire to improve their competency. Further work is needed to identify and trial practical strategies that help improve communication skills, knowledge, and the delivery of more equitable healthcare to RYP.
彩虹年轻人（RYP；具有不同性别、性取向和性别特征差异的人）在获得初级保健方面面临障碍，他们经常报告负面经历，并需要向临床医生传授有关彩虹特定问题的知识。本研究探讨了全科医生为 RYP 提供护理的观点和经验。
在新西兰奥克兰的一个城市地区的 5 家全科医生诊所进行了 3 次焦点小组讨论（共有 25 名参与者）。这些诊所是根据目的选择的，包括一些已知对 RYP 更友好的诊所，这些诊所有更多的 RYP 患者，而另一些则没有特别关注 RYP。每家诊所的所有成员，包括行政和接待人员，都被邀请参加。使用 NVivo 对焦点小组进行音频录制、转录和分析，采用归纳主题分析。
确定了四个主要主题：（i）实践经验，（ii）感到尴尬，（iii）知识和培训，以及（iv）结构障碍。健康提供者在向 RYP 提供护理方面的知识、舒适度和经验存在差异。参与者发现缺乏知识和培训，希望获得更多资源和教育。系统限制很常见（例如，用于记录性别的 IT 系统），并且经常导致尴尬的临床接触。
参与者认识到在向 RYP 提供护理方面的培训、知识和信心方面存在不足，并表示希望提高自己的能力。需要进一步努力，确定和试验有助于提高沟通技巧、知识和向 RYP 提供更公平医疗保健的实用策略。
