College of Life Sciences, University of Leicester, Leicester, UK
Department of Medical Psychology, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
BMJ Open. 2024 Aug 3;14(8):e084720. doi: 10.1136/bmjopen-2024-084720.
Patients identifying as lesbian, gay, bisexual, transgender and/or queer/questioning (LGBTQ+) report significant disparities in cancer care and are disproportionally affected by a cancer diagnosis on a number of health-related indicators. This study aimed to explore uterine cancer (UC) care from the perspectives of LGBTQ+ patients and stakeholders, to identify this population's care needs, which have been underprioritised thus far.
Qualitative interview data were collected from three cohorts of participants: LGBTQ+ UC patients, partners of UC patients and stakeholders who provide advocacy and/or support within the UC care pathway, including healthcare professionals (HCPs). Semi-structured qualitative interviews were conducted and data were analysed using inductive reflexive thematic analysis.
Fifteen participants (three patients, one partner, eight HCPs and three cancer support charity representatives) were recruited. Data analysis identified themes which represented participants' reflections on the relevance and opportunities for identity disclosure during the diagnostic pathway; feelings and implications of not fitting into the gynaecological cancer environment and, opportunities and challenges surrounding HCP education, and protocolled sexual and gender identity data collection.
UC patients who identify as LGBTQ+ have specific care needs and considerations, particularly related to transvaginal procedures and survivorship. Opportunities for disclosure of patients' LGBTQ+ identity during the UC care pathway are essential for these needs to be recognised. Despite this, there are conflicting agendas between HCPs and stakeholders on the best approach to integrate disclosure processes. The current findings highlight the need for public health agendas and clinical services to address the needs of LGBTQ+ UC patients.
被认定为女同性恋、男同性恋、双性恋、跨性别和/或酷儿/疑问（LGBTQ+）的患者在癌症护理方面存在显著差异，并且在许多与健康相关的指标上，他们受到癌症诊断的不成比例的影响。本研究旨在从 LGBTQ+ 患者和利益相关者的角度探讨子宫癌（UC）的护理，以确定迄今为止一直被忽视的这一人群的护理需求。
从三个参与者队列中收集了定性访谈数据：LGBTQ+UC 患者、UC 患者的伴侣以及在 UC 护理途径中提供宣传和/或支持的利益相关者，包括医疗保健专业人员（HCP）。进行了半结构化的定性访谈，使用归纳性反思主题分析对数据进行了分析。
共招募了 15 名参与者（3 名患者、1 名伴侣、8 名 HCP 和 3 名癌症支持慈善机构代表）。数据分析确定了代表参与者对诊断途径中身份披露的相关性和机会的主题；对不符合妇科癌症环境的感受和影响，以及围绕 HCP 教育的机会和挑战，以及协议的性和性别认同数据收集。
被认定为 LGBTQ+的 UC 患者有特定的护理需求和考虑因素，特别是与阴道检查和生存相关的需求和考虑因素。在 UC 护理途径中披露患者 LGBTQ+身份的机会对于识别这些需求至关重要。尽管如此，HCP 和利益相关者在整合披露过程的最佳方法上存在相互冲突的议程。目前的研究结果强调了公共卫生议程和临床服务需要解决 LGBTQ+UC 患者的需求。
