Lins-Kusterer Liliane, Vieira Nicolle Melo, Brites Carlos
Postgraduate Program in Medicine and Health, Federal University of Bahia, Av Reitor Miguel Calmon, s/n, Salvador, CEP 40110-100, Bahia, Brazil.
Int J Equity Health. 2024 Dec 18;23(1):265. doi: 10.1186/s12939-024-02351-9.
Despite the critical importance of humanized healthcare for transgender individuals, no existing measures specifically assess care humanization for this population. The Transgender Health Care Humanization Scale (THcH Scale) was developed to address this gap, yet it initially lacked confirmatory validation. This study validates the Transgender THcH scale for evaluating healthcare providers' sensitivity towards transgender patients.
This study involved 443 healthcare professionals and students from a public university and associated hospital. Participants were divided randomly into two groups for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett's Test of Sphericity, EFA confirmed data suitability for factor analysis. Factors were identified using parallel analysis with an oblique Promax rotation to allow for inter-factor correlations. The internal consistency of the factors was assessed using Cronbach's alpha. CFA was performed using Maximum Likelihood estimation, with goodness-of-fit evaluated by multiple indices. The THcH Scale's divergent validity was assessed through Spearman's correlation analysis with the Duke University Religion Index (DUREL).
Exploratory and Confirmatory Factor Analyses confirmed the scale's two-factor structure with excellent psychometric properties, including high internal consistency (Cronbach's alpha > 0.8) and good fit indices (χ²/df = 1.74, CFI = 0.972, TLI = 0.964, GFI = 0.989, RMSEA = 0.069, SRMR = 0.043). Divergent validity was established through moderate correlations with the DUREL index.
The THcH scale is a reliable and valid tool for promoting sensitivity and awareness among healthcare professionals, thereby enhancing healthcare access and quality for the transgender population. Further research should expand its application to primary care and diverse populations and settings.
尽管人性化医疗对跨性别者至关重要，但现有的措施均未专门评估针对这一人群的医疗人性化程度。跨性别医疗人性化量表（THcH量表）的开发正是为了填补这一空白，不过它最初缺乏验证性效度。本研究对跨性别THcH量表进行验证，以评估医疗服务提供者对跨性别患者的敏感度。
本研究纳入了一所公立大学及其附属医院的443名医疗专业人员和学生。参与者被随机分为两组，分别进行探索性因子分析（EFA）和验证性因子分析（CFA）。通过Kaiser-Meyer-Olkin抽样适当性度量和Bartlett球形检验，EFA确认数据适合进行因子分析。使用平行分析和斜交Promax旋转来识别因子，以考虑因子间的相关性。使用Cronbach's alpha评估因子的内部一致性。CFA采用最大似然估计法进行，通过多个指标评估拟合优度。通过与杜克大学宗教指数（DUREL）进行Spearman相关分析，评估THcH量表的区分效度。
探索性因子分析和验证性因子分析均证实了该量表的两因子结构，其具有出色的心理测量学特性，包括高内部一致性（Cronbach's alpha＞0.8）和良好的拟合指标（χ²/df = 1.74，CFI = 0.972，TLI = 0.964，GFI = 0.989，RMSEA = 0.069，SRMR = 0.043）。通过与DUREL指数的中等相关性建立了区分效度。
THcH量表是一种可靠且有效的工具，可提高医疗专业人员的敏感度和意识，从而改善跨性别群体的医疗可及性和质量。进一步的研究应将其应用扩展到初级保健以及不同人群和环境中。
