Schultz Theresa Ryan, Edemba Desiree, Lecuyer Matthew E, Garzone Allison, Henise Shane, Liljestrand Amy, Hinds Pamela S, King Simmy
Children's National Hospital, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Public Health Nurs. 2025 Mar-Apr;42(2):957-965. doi: 10.1111/phn.13480. Epub 2024 Dec 2.
Health equity is actualized when all individuals can attain the highest level of health. Youth who identify as LGBTQ+ experience health disparities and scarce access to culturally congruent mental healthcare. Our nurse-led research team recognized evidence-based practice guidance gaps and prioritized a systematic inquiry into the lived experiences of LGBTQ+ identifying youth who needed emergency care for suicidality. Concurrently, we translated new findings into practice. The purpose of this endeavor is to implement a nimble evidence-based practice adoption process for nursing staff to effectively address LGBTQ+ population health needs.
Informed by Purnell's Cultural Competence Theory, qualitative findings from a prospective study and available literature, we developed an LGBTQ+ sensitive care curriculum for nursing staff using the American Nurses Credentialing Center's (ANCC) Nursing Continuing Education Professional Development (NCPD) Framework to address the intersectionality of cultural awareness and care provision. The curriculum was delivered and formally evaluated longitudinally with a focus on communication confidence and knowledge.
The curriculum was delivered in one session to nursing staff during a 6-month period. Program evaluations indicated curriculum acceptability and effectiveness. Participants reported improved ability to use appropriate language when communicating with patients who identify as LGBTQ+ and their families and a moderate to high change in confidence when providing care to LGBTQ+ identifying patients.
Concurrent, evidence-based efforts to uncover and apply new knowledge relevant to nursing communication with youth who identify as LGBTQ+ is possible and yield effective, positive change in nursing knowledge and confidence in providing care for these youth. Implementation science is essential to advance evidence-based nursing practice or the full positive impact of research on patient outcomes is not likely. When the implementation science program is not incorporated early in the research process, research excellence is at risk. Evolving evidence-based practices that enhance individualized holistic patient care delivery for LGBTQ+ individuals are strengthened when primary research, implementation science, and scaling research co-occurrence is achievable.
This implementation strategy demonstrates that early translation of health equity research on culturally congruent care for individuals identifying as LGBTQ+ can be done effectively and replicated across practice settings. Further, this work validates the importance of the relationship between nurse scientists, translational scientists, and clinical practice and education experts in the early dissemination and adoption of new knowledge. Evidence-based practice adoption improves healthcare professionals' propensity to positively impact public health patient care outcomes.
Nursing staff are equipped with the knowledge and skills to deliver equitable care. Dissemination of early research findings as an implementation science strategy supports concurrent adoption in clinical practice to advance health equity outcomes with urgency.
No patient or public contribution.
当所有人都能达到最高健康水平时,健康公平就得以实现。自我认同为 LGBTQ+ 的青少年面临健康差异,且难以获得符合其文化背景的心理保健服务。我们由护士主导的研究团队认识到基于证据的实践指导存在差距,并优先对那些因自杀倾向而需要急诊护理的自我认同为 LGBTQ+ 的青少年的生活经历进行系统探究。与此同时,我们将新发现转化为实践。这一努力的目的是为护理人员实施一个灵活的基于证据的实践采用过程,以有效满足 LGBTQ+ 人群的健康需求。
以前瞻性研究的定性结果和现有文献为依据,受普尔内尔文化能力理论的启发,我们利用美国护士认证中心(ANCC)的护理继续教育专业发展(NCPD)框架,为护理人员开发了一门对 LGBTQ+ 敏感的护理课程,以解决文化意识与护理提供的交叉问题。该课程进行了授课,并从纵向角度进行了正式评估,重点是沟通信心和知识。
该课程在6个月内分一次课向护理人员进行了讲授。项目评估表明了课程的可接受性和有效性。参与者报告称,在与自我认同为 LGBTQ+ 的患者及其家人沟通时,使用恰当语言的能力有所提高,在为自我认同为 LGBTQ+ 的患者提供护理时,信心有中度到高度的提升。
同时开展基于证据的工作,以发现并应用与护理人员与自我认同为 LGBTQ+ 的青少年沟通相关知识是可行的,并且能在护理知识以及为这些青少年提供护理的信心方面产生有效、积极的变化。实施科学对于推进基于证据的护理实践至关重要,否则研究对患者结局的全部积极影响可能无法实现。当实施科学项目未在研究过程早期纳入时,卓越的研究就会面临风险。当能够实现基础研究、实施科学和推广研究同时进行时,不断发展的基于证据的实践会得到加强,这些实践可增强为 LGBTQ+ 个体提供个性化整体护理的服务。
这一实施策略表明,关于为自我认同为 LGBTQ+ 的个体提供符合其文化背景护理的健康公平研究能够有效地尽早转化,并能在不同实践环境中复制。此外,这项工作验证了护士科学家、转化科学家以及临床实践和教育专家之间的关系在新知识早期传播和采用中的重要性。采用基于证据的实践可提高医疗保健专业人员对公共卫生患者护理结局产生积极影响的倾向。
护理人员具备了提供公平护理的知识和技能。将早期研究结果作为实施科学策略进行传播,支持在临床实践中同时采用,以紧急推进健康公平成果。
无患者或公众参与。