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马来西亚LGBT+群体的心理健康护理需求与经历:效用、促进因素及障碍

Mental Healthcare Needs and Experiences of LGBT+ Individuals in Malaysia: Utility, Enablers, and Barriers.

作者信息

Ho Sheau Huey, Shamsudin Amirul Hakim, Liow Jun Wei, Juhari Johan Ariff, Ling Sai Ang, Tan Kyle

机构信息

Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia.

Department of English, Faculty of Languages and Linguistics, Universiti Malaya, Kuala Lumpur 50603, Malaysia.

出版信息

Healthcare (Basel). 2024 May 13;12(10):998. doi: 10.3390/healthcare12100998.

Abstract

Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey ( = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments ( = 273), with relevance drawn to Andersen's Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners' stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.

摘要

鉴于少数群体压力暴露导致心理健康问题的高发生率,获得心理保健服务对全球 LGBT+ 人群无疑至关重要。本研究从基于社区的 KAMI 调查(n = 696)中提取了混合方法的调查数据,以考察马来西亚 LGBT+ 个体在获得心理保健服务方面的促进因素、障碍和未满足的需求体验。首先,我们展示了一系列描述性分析的结果,这些分析涉及心理保健未满足需求、障碍以及对不同类型心理保健的满意度水平方面的社会人口统计学差异。接下来,我们对开放式文本评论(n = 273)进行了归纳主题分析,并与安德森的医疗保健行为模型相关联。超过四分之一(29.5%)的人报告有心理保健未满足的需求,一些群体(年轻人、无性恋或酷儿群体,或居住在非主要城市的参与者)报告的未满足需求更高。超过五分之三(60.5%)的人报告不知道在哪里可以找到具有文化安全性的心理健康专业人员。主题分析揭示了影响医疗保健体验的关键背景因素(如心理健康从业者的立场、耻辱感、协作式客户护理)和个人因素(如对心理健康服务的积极期望和预期的耻辱感)。参与者还确定了促进医疗保健利用的资源,如可承受性、合适专业人员的可获得性以及地理因素。我们概述了研究结果对马来西亚心理保健实践的影响。

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