Power Rosalie, Ussher Jane M, Allison Kimberley, Hawkey Alexandra, Perz Janette
Translational Health Research Institute, Western Sydney University, Sydney, Australia.
J Cancer Surviv. 2024 Sep 21. doi: 10.1007/s11764-024-01677-1.
Lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI) people face unique challenges in cancer care. This mixed methods study examined LGBTQI patients' satisfaction with cancer care and factors associated with satisfaction, including experiences of LGBTQI disclosure. The study also explored what helps to facilitate safe disclosure and improve satisfaction with care for this population.
We used a mixed methods approach, involving 430 surveys and 104 semi-structured interviews with LGBTQI people with cancer (16-92 years) with various cancer types, sexuality and gender identities, ages, and people with intersex variations.
Most participants reported being satisfied with their cancer care (n = 300, 76.3%) and had disclosed their LGBTQI sexuality or gender identity or intersex variations to at least some of their cancer healthcare professionals (HCPs) (n = 357, 87.1%). Satisfaction with care was higher with more disclosure to HCPs, HCP acknowledgment of partner/s and support people, and the ability to find LGBTQI specific information about cancer; it was lower with reports of discrimination in cancer care. Qualitative analysis identified that some participants were always out to HCPs, but others felt burdened with the responsibility and emotion work of disclosure and feared negative responses. Same-gender intimate partners facilitated disclosure and need to be respected within cancer care.
HCPs need to take the lead in facilitating LGBTQI disclosure in cancer care. Targeted interventions and training for HCPs, including reception and administration staff, are crucial to ensure equitable, affirming cancer care for all LGBTQI patients, ultimately leading to improved satisfaction with cancer care.
Creating safe and inclusive environments for LGBTQI cancer patients is essential to encourage disclosure and improve satisfaction with cancer care.
女同性恋、男同性恋、双性恋、跨性别者、酷儿及双性人（LGBTQI）群体在癌症护理方面面临独特挑战。这项混合方法研究调查了LGBTQI患者对癌症护理的满意度以及与满意度相关的因素，包括LGBTQI身份披露的经历。该研究还探讨了有助于促进安全披露并提高该群体对护理满意度的因素。
我们采用了混合方法，对430名癌症患者（年龄在16 - 92岁之间）进行了调查，并对104名LGBTQI癌症患者进行了半结构化访谈，这些患者患有各种癌症类型，具有不同的性取向、性别认同、年龄以及双性人变异情况。
大多数参与者表示对癌症护理感到满意（n = 300，76.3%），并且至少向部分癌症医护人员披露了他们的LGBTQI性取向、性别认同或双性人变异情况（n = 357，87.1%）。向医护人员披露得越多、医护人员对伴侣及支持人员的认可、以及能够找到关于癌症的LGBTQI特定信息，护理满意度越高；而癌症护理中存在歧视报告时，满意度则较低。定性分析表明，一些参与者总是向医护人员公开身份，但另一些人则感到披露身份的责任和情感工作负担沉重，并担心会得到负面回应。同性亲密伴侣有助于披露身份，在癌症护理中需要得到尊重。
医护人员需要带头促进在癌症护理中LGBTQI身份的披露。针对医护人员（包括接待和行政人员）的有针对性干预和培训对于确保为所有LGBTQI患者提供公平、肯定的癌症护理至关重要，最终可提高对癌症护理的满意度。
为LGBTQI癌症患者创造安全和包容的环境对于鼓励披露身份并提高对癌症护理的满意度至关重要。
