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女同性恋、男同性恋、双性恋和跨性别者(LGBT)文化能力培训与医疗服务提供者的实践特征及患者护理认知的关联

Association of Lesbian, Gay, Bisexual, and Transgender (LGBT) Cultural Competency Training With Provider Practice Characteristics and Perceptions of Patient Care.

作者信息

Hsiang Elaine, Ney John P, Weathers Allison L, Rosendale Nicole

机构信息

Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA.

Department of Neurology, Yale University, New Haven, CT, USA.

出版信息

J Med Educ Curric Dev. 2024 Oct 1;11:23821205241287441. doi: 10.1177/23821205241287441. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND

While issues related to lesbian, gay, bisexual, and transgender (LGBT) health are increasingly incorporated into medical training, there remains limited guidance and opportunities for continuing medical education in LGBT health. It is unclear how participation in LGBT-specific training is distributed across physician specialties and practice regions. Additionally, national data assessing cultural competency training for physicians are scarce and do not delineate LGBT-specific training or training completed prior to, during, or after graduate medical education.

METHODS

Using data from the 2016 National Culturally and Linguistically Appropriate Services Physician Survey, this study evaluated patterns of post-residency cultural competency training, as well as associations between LGBT-specific training and provider perceptions of patient care outcomes.

RESULTS

Provider specialty, practice region, and receiving cultural competency training as a trainee were associated with post-residency LGBT-specific training. Surgical providers (odds ratio [OR]: 0.42; confidence interval [CI] 0.25-0.73;  = .002) and those practicing in the South (OR: 0.49; CI: 0.26-0.92;  = .025) had lower odds of completing LGBT-specific cultural competency training while in independent practice. Post-residency LGBT-specific training was associated with provider agreement that cultural competency training improves the quality of care (OR: 2.76; CI: 1.44-5.28;  = .002), patient satisfaction (OR: 2.55; CI: 1.32-4.93;  = .005), and patient comprehension (OR: 2.03; CI: 1.05-3.90;  = .034).

CONCLUSIONS

Our findings provide disaggregated analyses that nuance the assessment of cultural competency interventions and support a broader effort to increase attention to LGBT health in continuing medical education.

摘要

背景

虽然与女同性恋、男同性恋、双性恋和跨性别者(LGBT)健康相关的问题越来越多地纳入医学培训,但LGBT健康方面的继续医学教育指导和机会仍然有限。目前尚不清楚LGBT特定培训在不同医生专业和执业地区的参与情况如何分布。此外,评估医生文化能力培训的全国性数据稀缺,且未区分LGBT特定培训或在毕业后医学教育之前、期间或之后完成的培训。

方法

本研究使用2016年全国文化和语言适当服务医生调查的数据,评估了住院医师培训后文化能力培训的模式,以及LGBT特定培训与提供者对患者护理结果的看法之间的关联。

结果

提供者的专业、执业地区以及作为受训者接受文化能力培训与住院医师培训后的LGBT特定培训相关。外科医生(优势比[OR]:0.42;置信区间[CI]0.25 - 0.73;P = 0.002)和在南方执业的医生(OR:0.49;CI:0.26 - 0.92;P = 0.025)在独立执业时完成LGBT特定文化能力培训的几率较低。住院医师培训后的LGBT特定培训与提供者认同文化能力培训可提高护理质量(OR:2.76;CI:1.44 - 5.28;P = 0.002)、患者满意度(OR:2.55;CI:1.32 - 4.93;P = 0.005)和患者理解度(OR:2.03;CI:1.05 - 3.90;P = 0.034)相关。

结论

我们的研究结果提供了分类分析,细化了对文化能力干预措施的评估,并支持在继续医学教育中更广泛地努力提高对LGBT健康的关注。

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LGBT healthcare disparities: What progress have we made?LGBT 健康差异:我们取得了哪些进展?
Patient Educ Couns. 2017 Dec;100(12):2357-2361. doi: 10.1016/j.pec.2017.06.003. Epub 2017 Jun 10.

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