Raque Trisha L, Bashakevitz Kat, Wright Orphea, Scout Nfn
Department of Counseling Psychology, University of Denver, Denver, Colorado, USA.
National LGBT Cancer Network, Providence, Rhode Island, USA.
LGBT Health. 2024 Jul;11(5):406-413. doi: 10.1089/lgbt.2023.0299. Epub 2024 Jan 12.
Sexual and gender minority (SGM) cancer survivors report unique needs that are not met by some providers. The multicultural orientation (MCO) holds promise for creating a paradigm shift in providing affirmative cancer care, yet has not been tested empirically. This study examines the predictive strength of MCO's tenets of cultural humility and cultural opportunities for SGM cancer patient-provider relationships. In this cross-sectional study, 108 SGM cancer survivors completed surveys on perceptions of their oncology providers' cultural humility and actualization of cultural opportunities as predictors of survivors' treatment adherence and the patient-provider alliance. Hierarchical regression analyses were conducted. Average participant age was 50 years ( = 15 years). Over 10 cancer types were represented and 69% of participants were in active treatment, with the remaining 31% receiving follow-up care. Age at diagnosis and not being in active treatment positively correlated with perceptions of providers' cultural humility, patient-provider alliance, and treatment adherence. Regression models explained 38% and 61%, respectively, of the variance in treatment adherence and patient-provider alliance, with cultural humility remaining a significant predictor in both models after accounting for all other variables. Providers' cultural humility and navigation of cultural opportunities in incorporating their patients' salient cultural identities into cancer care are strongly associated with how supported SGM cancer survivors feel by their oncology providers. The MCO is a useful framework for identifying important dimensions in SGM affirmative cancer care.
性与性别少数群体（SGM）癌症幸存者报告了一些独特需求，而部分医疗服务提供者无法满足这些需求。多元文化取向（MCO）有望在提供肯定性癌症护理方面带来范式转变，但尚未经过实证检验。本研究考察了MCO中文化谦逊和文化机会原则对SGM癌症患者与医疗服务提供者关系的预测强度。在这项横断面研究中，108名SGM癌症幸存者完成了关于其对肿瘤医疗服务提供者文化谦逊的看法以及文化机会实现情况的调查，这些被视为幸存者治疗依从性和患者与医疗服务提供者联盟的预测因素。进行了分层回归分析。参与者的平均年龄为50岁（标准差 = 15岁）。涵盖了超过10种癌症类型，69%的参与者正在接受积极治疗，其余31%接受随访护理。诊断时的年龄以及未接受积极治疗与对医疗服务提供者文化谦逊、患者与医疗服务提供者联盟以及治疗依从性的看法呈正相关。回归模型分别解释了治疗依从性和患者与医疗服务提供者联盟中38%和61%的方差，在考虑所有其他变量后，文化谦逊在两个模型中仍然是一个显著预测因素。医疗服务提供者的文化谦逊以及在将患者突出的文化身份纳入癌症护理中对文化机会的把握，与SGM癌症幸存者感受到肿瘤医疗服务提供者的支持程度密切相关。MCO是识别SGM肯定性癌症护理中重要维度的有用框架。
