Gold Beck, Lei Pin-Ji, Kamran Sophia C, Haas-Kogan Daphne A, Franco Idalid, Zietman Anthony L, Smart Alicia C, Wo Jennifer Y
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Adv Radiat Oncol. 2024 Feb 6;9(5):101461. doi: 10.1016/j.adro.2024.101461. eCollection 2024 May.
Sexual and gender minority (SGM) individuals have an increased risk of poor health outcomes, in part due to knowledge and training gaps in health care education. This study sought to evaluate the knowledge, attitudes, and practice behaviors of various health care role groups within radiation oncology toward SGM patients.
A 38-item web-based survey was emailed to 1045 staff across 2 large radiation oncology departments. The survey assessed demographics, attitudes, knowledge, and practice behaviors. χ tests were performed to explore differences in survey responses by age, political affiliation, religious identity, year since graduation, and role groups. One-way analysis of variance tests were conducted to determine differences between respondents' confidence in knowledge and performance on the knowledge section of the survey. Thematic analysis was applied to the open discussion section.
Of the 223 respondents, 103 clinicians (physicians/advanced practice providers/nurses) and 120 nonclinicians (administrative staff, medical assistants, and other nonmedical staff) participated in the survey (21.3% response rate): 72.6% answered the knowledge questions; 93.5% stated they were comfortable treating sexual minorities, or lesbian, gay, bisexual, and queer + patients; 88% indicated comfort in treating transgender patients; 36.6% stated they were confident in their knowledge of the health needs of transgender patients; and 50.3% expressed confidence in treating lesbian, gay, bisexual, and queer + patients. Fewer nonclinicians than clinicians thought that gender identity, sexual orientation, and sex assigned at birth were important to provide the best care ( < .05). The open comments section identified key themes, including the belief that current educational tools are not helpful, desire for more educational formats (lectures, case-based learning, seminars), and an overall interest in SGM health education.
Most staff feel comfortable in treating SGM patients but are less confident in the distinct needs of this population. Knowledge gaps persist for both clinicians and nonclinicians, indicating a need for further training specific to oncology care.
性取向和性别少数群体（SGM）个体健康状况不佳的风险增加，部分原因是医疗保健教育方面存在知识和培训差距。本研究旨在评估放射肿瘤学领域不同医疗保健角色群体对SGM患者的知识、态度和实践行为。
通过电子邮件向两个大型放射肿瘤学部门的1045名工作人员发送了一份包含38个项目的网络调查问卷。该调查评估了人口统计学、态度、知识和实践行为。进行χ检验以探讨年龄、政治派别、宗教身份、毕业年份和角色群体在调查回复上的差异。进行单因素方差分析测试以确定受访者在知识方面的信心与调查知识部分表现之间的差异。对开放式讨论部分进行主题分析。
在223名受访者中，103名临床医生（医生/高级执业提供者/护士）和120名非临床医生（行政人员、医疗助理和其他非医疗人员）参与了调查（回复率为21.3%）：72.6%回答了知识问题；93.5%表示他们愿意治疗性少数群体或女同性恋、男同性恋、双性恋和酷儿+患者；88%表示愿意治疗跨性别患者；36.6%表示他们对自己了解跨性别患者的健康需求有信心；50.3%表示有信心治疗女同性恋、男同性恋、双性恋和酷儿+患者。认为性别认同、性取向和出生时指定的性别对于提供最佳护理很重要的非临床医生比临床医生少（P<0.05）。开放式评论部分确定了关键主题，包括认为当前的教育工具没有帮助、希望有更多教育形式（讲座、基于案例的学习、研讨会）以及对SGM健康教育的总体兴趣。
大多数工作人员愿意治疗SGM患者，但对该人群的独特需求信心不足。临床医生和非临床医生都存在知识差距，这表明需要针对肿瘤护理进行进一步培训。
