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加拿大医疗保健系统中当前 2SLGBTQIA+ 不平等现象的综述。

Review of current 2SLGBTQIA+ inequities in the Canadian health care system.

机构信息

Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Center, Research Sector, Moncton, NB, Canada.

School of Public Policy Studies, Université de Moncton, Moncton, NB, Canada.

出版信息

Front Public Health. 2023 Jul 18;11:1183284. doi: 10.3389/fpubh.2023.1183284. eCollection 2023.

Abstract

Gender identity and sexual orientation are determinants of health that can contribute to health inequities. In the 2SLGBTQIA+ community, belonging to a sexual and/or gender minority group leads to a higher risk of negative health outcomes such as depression, anxiety, and cancer, as well as maladaptive behaviors leading to poorer health outcomes such as substance abuse and risky sexual behavior. Empirical evidence suggests that inequities in terms of accessibility to health care, quality of care, inclusivity, and satisfaction of care, are pervasive and entrenched in the health care system. A better understanding of the current Canadian health care context for individuals of the 2SLGBTQIA+ community is imperative to inform public policy and develop sensitive public health interventions to make meaningful headway in reducing inequity. Our search strategy was Canadian-centric and aimed at highlighting the current state of 2SLGBTQIA+ health inequities in Canada. Discrimination, patient care and access to care, education and training of health care professionals, and crucial changes at the systemic and infrastructure levels have been identified as main themes in the literature. Furthermore, we describe health care-related disparities in the 2SLGBTQIA+ community, and present available resources and guidelines that can guide healthcare providers in narrowing the gap in inequities. Herein, the lack of training for both clinical and non-clinical staff has been identified as the most critical issue influencing health care systems. Researchers, educators, and practitioners should invest in health care professional training and future research should evaluate the effectiveness of interventions on staff attitudinal changes toward the 2SLGBTQIA+ community and the impact on patient outcomes.

摘要

性别认同和性取向是健康的决定因素,它们可能导致健康不平等。在 2SLGBTQIA+ 群体中,属于性少数群体和/或性别少数群体,会导致更高的负面健康结果风险,如抑郁、焦虑和癌症,以及导致更差的健康结果的适应不良行为,如药物滥用和危险性行为。实证证据表明,在获得医疗保健、护理质量、包容性和护理满意度方面存在的不平等现象在医疗保健系统中普遍存在且根深蒂固。更好地了解 2SLGBTQIA+ 群体在加拿大的当前医疗保健背景,对于为公共政策提供信息并制定敏感的公共卫生干预措施,以在减少不平等方面取得有意义的进展至关重要。我们的搜索策略以加拿大为中心,旨在突出加拿大 2SLGBTQIA+ 健康不平等的现状。歧视、患者护理和获得护理、医疗保健专业人员的教育和培训以及系统和基础设施层面的关键变革已被确定为文献中的主要主题。此外,我们描述了 2SLGBTQIA+ 群体中与医疗保健相关的差异,并介绍了可用的资源和指南,这些资源和指南可以指导医疗保健提供者缩小不平等差距。在此,临床和非临床人员缺乏培训被确定为影响医疗保健系统的最关键问题。研究人员、教育工作者和从业者应投资于医疗保健专业人员的培训,未来的研究应评估干预措施对工作人员对 2SLGBTQIA+ 群体的态度变化及其对患者结果的影响的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0537/10392841/e4bb016d2a48/fpubh-11-1183284-g001.jpg

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