Roy Emily E, Clark Kristen D
Department of Nursing, University of New Hampshire, Hewitt Hall, 4 Library Way, Durham, NH, USA.
Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Ingång 10, Plan 3, Uppsala, 751 85, Sweden.
BMC Nurs. 2024 Dec 21;23(1):943. doi: 10.1186/s12912-024-02618-0.
While efforts to improve the educational preparedness of nurses to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ +) people have increased, the influence of role-modeled behaviors by healthcare professionals working with nursing students and recent graduates is not well understood. The purpose of this study is to describe the role-modeled behaviors of healthcare professionals observed by nursing students and recent graduates caring for LGBTQ + patients in clinical settings.
A cross-sectional, online survey was conducted. Recruitment of nursing students who had completed one or more clinical rotations or were recent graduates (≤ 2 years) was performed through university emails and social media. Items included measurement of stigmatizing attitudes, observed stigmatizing behaviors, and ability to provide inclusive/affirming care for LGBTQ + patients. Open-text items prompted participants to describe observed behaviors. Data were analyzed using descriptive statistics and Wilcoxon signed rank sum tests to evaluate differences between LGB (lesbian, gay, bisexual) and T + (transgender and gender diverse) subscales. Open-text responses were analyzed using thematic analysis to identify relevant themes.
Participants (N = 73) had a low level of stigmatizing attitudes toward LGBTQ + people (M = 1.8, SD = 0.4), although higher stigmatizing attitudes toward T + people were reported (M = 3.0, SD = 0.2; Z = -7.254, p < .001). Half of the participants reported that they observed LGBTQ + stigmatizing behaviors role-modeled by two + healthcare professional roles; approximately one-third of participants personally engaged in one + LGBTQ + stigmatizing behaviors, most commonly toward T + people. Themes from participants' examples of observed stigmatizing behaviors included: cis-heteronormative bias, non-affirmation of chosen name/pronouns, outing patients, and rejected competency.
The majority of participants described observing stigmatizing behaviors toward LGBTQ + people in clinical settings. Poorer attitudes and a higher frequency of stigmatizing behaviors observed towards T + people point to deficits in healthcare provided to T + people in particular. Efforts to address LGBTQ + stigma in healthcare should be expanded to include clinical settings to address role-modeled behaviors and socialization of nurses.
虽然提高护士照顾女同性恋、男同性恋、双性恋、跨性别和酷儿（LGBTQ+）人群的教育准备工作的力度有所加大，但与护理专业学生和应届毕业生一起工作的医疗保健专业人员的榜样行为的影响尚未得到充分理解。本研究的目的是描述护理专业学生和应届毕业生在临床环境中照顾LGBTQ+患者时所观察到的医疗保健专业人员的榜样行为。
进行了一项横断面在线调查。通过大学电子邮件和社交媒体招募已完成一次或多次临床轮转或为应届毕业生（≤2年）的护理专业学生。项目包括对污名化态度、观察到的污名化行为以及为LGBTQ+患者提供包容性/肯定性护理的能力的测量。开放式文本项目促使参与者描述观察到的行为。使用描述性统计和Wilcoxon符号秩和检验分析数据，以评估LGB（女同性恋、男同性恋、双性恋）和T+（跨性别和性别多样化）子量表之间的差异。使用主题分析对开放式文本回复进行分析，以确定相关主题。
参与者（N = 73）对LGBTQ+人群的污名化态度较低（M = 1.8，SD = 0.4），尽管对T+人群的污名化态度较高（M = 3.0，SD = 0.2；Z = -7.254，p <.001）。一半的参与者报告说，他们观察到由两个或更多医疗保健专业角色示范的LGBTQ+污名化行为；大约三分之一的参与者亲自参与了一种或多种LGBTQ+污名化行为，最常见的是针对T+人群。参与者观察到的污名化行为示例中的主题包括：顺性别异性恋规范偏见、不认可所选姓名/代词、暴露患者身份以及拒绝承认能力。
大多数参与者描述了在临床环境中观察到的针对LGBTQ+人群的污名化行为。对T+人群观察到的较差态度和较高频率的污名化行为尤其表明为T+人群提供的医疗保健存在缺陷。解决医疗保健中LGBTQ+污名化问题的努力应扩大到包括临床环境，以解决护士的榜样行为和社会化问题。
