School of Nursing, Dalhousie University, Halifax, NS, Canada.
Qual Health Res. 2023 Jun;33(7):624-637. doi: 10.1177/10497323231167828. Epub 2023 Apr 18.
Previous research inadequately explores processes and factors influencing the delivery of health services to sexual and gender minorities in ways that equitably attend to the infinite diversity held by these groups. This study employed Intersectionality and Critical Theories to inform Constructivist Grounded Theory methods and methodology; social categories of identity were strategically adopted to explore domains of power operating across multiple forms of oppression, think through subjective realities, and generate a nuanced rendering of power relations influencing health service delivery to diverse 2SLGBTQ populations in a Canadian province. Semi-structured interviews were conducted and the co-constructed theory of , with three interrelated concepts, , , and , was generated The theory depicts the concerns of participants and what they do about power relations influencing health service delivery and broader social contexts. While the negative impacts of stigma were widely and diversely experienced by patients and providers, ways of working within power relations emerged that would be impossible if stigma was not present, highlighting opportunities to positively impact those from stigmatized groups. As such, is a theory that flouts the tradition of stigma research; it offers theoretical knowledge that can be used to work within power relations upholding stigma in ways that increase access to quality health services for those whose historical underservicing can be attributed to stigma. In doing so, the stigma script is flipped and strategies for working against practices and behaviours that uphold cultural supremacies may be realized.
先前的研究在以公平的方式关注这些群体所具有的无限多样性的情况下，未能充分探讨影响向性和性别少数群体提供卫生服务的过程和因素。本研究采用交叉性和批判理论为建构主义扎根理论方法和方法论提供信息；身份的社会类别被战略性地采用，以探索跨越多种形式压迫的权力领域，思考主观现实，并对影响加拿大一个省向不同 2SLGBTQ 人群提供卫生服务的权力关系进行细致入微的描绘。进行了半结构化访谈，并生成了 的共同构建理论，该理论包含三个相互关联的概念： 、 、 和 。该理论描述了参与者的关注点以及他们对影响卫生服务提供和更广泛社会背景的权力关系所采取的行动。虽然患者和提供者广泛而多样化地经历了污名的负面影响，但出现了在存在污名的情况下不可能出现的处理权力关系的方式，这突显了为那些受到污名化的群体带来积极影响的机会。因此， 是一种颠覆污名研究传统的理论；它提供了可以用来在维护污名的权力关系中工作的理论知识，以增加那些由于污名而服务不足的人的优质卫生服务的获取。这样做，污名的剧本就被颠覆了，反对维护文化至上主义的实践和行为的策略就可以实现。
