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Azzellino G, Aitella E, Ginaldi L, De Martinis M. Barriers and Nursing Strategies in Oncology Care for LGBTQIA+ People: A Scoping Review. Cancers (Basel) 2025; 17:1146. [PMID: 40227714 PMCID: PMC11987977 DOI: 10.3390/cancers17071146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Revised: 03/21/2025] [Accepted: 03/24/2025] [Indexed: 04/15/2025] Open
Abstract
LGBTQIA+ individuals with cancer face significant challenges in their interactions with nurses, which can negatively affect the quality of care, treatment adherence, and access to healthcare. Barriers such as implicit biases, discrimination, and inadequate communication skills contribute to these disparities, alongside a lack of nursing education on gender and sexual diversity. Despite the recognized role of nurses in reducing health inequalities, knowledge about effective strategies to overcome these barriers remains fragmented. This scoping review aims to identify and categorize the main barriers affecting the nurse-patient relationship in oncology and to explore evidence-based nursing interventions that promote equitable and inclusive care. A systematic literature search was conducted between January and February 2025 in PUBMED, SCOPUS, and Web of Science, including studies published in the last 10 years. Study management was performed using Zotero (version 6.0.30), and quality assessment was conducted with the JBI Critical Appraisal Tools. Two independent reviewers screened the studies, resolving discrepancies through discussion and consensus. This review follows the PRISMA-ScR checklist and the JBI scoping review methodology. The findings will provide insights into the primary barriers, highlight effective nursing interventions, and identify gaps in education and clinical guidelines, contributing to the development of more inclusive oncology care practices.
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Affiliation(s)
- Gianluca Azzellino
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.A.); (L.G.)
- Complex Operational Unit, Adriatic District Area, AUSL 04 Teramo, Italy
| | - Ernesto Aitella
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.A.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.A.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.A.); (L.G.)
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
- Long-Term Care Unit, “Maria SS. dello Splendore” Hospital, Giulianova, AUSL 04 Teramo, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
- “Teramo hub” University of L’Aquila, 67100 L’Aquila, Italy
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Kuney MA, Noble MD, Stubbs DM. LGBTQIA+ cultural competency in healthcare education programs: A scoping review. Nurse Educ Pract 2025; 84:104333. [PMID: 40174474 DOI: 10.1016/j.nepr.2025.104333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 02/22/2025] [Accepted: 03/09/2025] [Indexed: 04/04/2025]
Abstract
AIM/OBJECTIVE To explore and summarise existing literature concerning strategies for increasing LGBTQIA+ cultural and clinical competency in healthcare education programs. BACKGROUND Cultural and systemic changes in countries are needed to address the pervasive health disparities facing the LGBTQIA+ population. Understanding current global LGBTQIA+ content in education programs is pivotal for informing future curriculum development and producing culturally competent clinicians who can then undertake the creation clinical competency standards. DESIGN A scoping review. METHODS CINAHL, Ovid, Clinical key, Medline and PubMed were searched between October 2023 and August 2024. The review followed the JBI critical appraisal tools and methodological approach to scoping reviews. RESULTS Twenty-five papers met eligibility criteria. Four themes emerged: (i) Significant Gains in Knowledge and Cultural Competency through LGBTQIA+ Training, (ii) Identified Gaps and the Need for Standardisation in LGBTQIA+ Healthcare Education (iii) The Role of Faculty Development and Community Engagement in Effective LGBTQIA+ Curriculum Integration and (iv) Addressing Intersecting Identities and Health Disparities for LGBTQIA+ Populations. CONCLUSION The presence of gaps in training, particularly concerning gender identity and intersectionality, highlights the need for standardised curricula and faculty development.
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Affiliation(s)
- Ms Allison Kuney
- School of Nursing and Midwifery, University of Newcastle, Australia.
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Azzellino G, Ginaldi L, De Martinis M. Iron deficiency and iron deficiency anemia in transgender populations: what's different? Clin Chem Lab Med 2025; 63:e67-e69. [PMID: 39576668 DOI: 10.1515/cclm-2024-1185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Accepted: 11/11/2024] [Indexed: 01/29/2025]
Affiliation(s)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Long-Term Care Unit, "Maria SS. Dello Splendore" Hospital, Teramo, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
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Azzellino G, Ginaldi L, De Martinis M. A Biosocial Roadmap to Tackle the Burden of Hepatitis C Virus Infections That Ensures Health Equity for All. Clin Infect Dis 2025:ciae623. [PMID: 39936455 DOI: 10.1093/cid/ciae623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2025] Open
Affiliation(s)
- Gianluca Azzellino
- U.O.C. Area Distrettuale Adriatica, ASL 4 Teramo, Teramo, Italy
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, ASL 4 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, ASL 4 Teramo, Giulianova, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
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Dhamala E, Ricard JA, Uddin LQ, Galea LAM, Jacobs EG, Yip SW, Yeo BTT, Chakravarty MM, Holmes AJ. Considering the interconnected nature of social identities in neuroimaging research. Nat Neurosci 2025; 28:222-233. [PMID: 39730766 DOI: 10.1038/s41593-024-01832-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 10/24/2024] [Indexed: 12/29/2024]
Abstract
Considerable heterogeneity exists in the expression of complex human behaviors across the cognitive, personality and mental health domains. It is increasingly evident that individual variability in behavioral expression is substantially affected by sociodemographic factors that often interact with life experiences. Here, we formally address the urgent need to incorporate intersectional identities in neuroimaging studies of behavior, with a focus on research in mental health. We highlight how diverse sociodemographic factors influence the study of psychiatric conditions, focusing on how interactions between those factors might contribute to brain biology and illness expression, including prevalence, symptom burden, help seeking, treatment response and tolerance, and relapse and remission. We conclude with a discussion of the considerations and actionable items related to participant recruitment, data acquisition and data analysis to facilitate the inclusion and incorporation of diverse intersectional identities in neuroimaging.
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Affiliation(s)
- Elvisha Dhamala
- Feinstein Institutes for Medical Research, Manhasset, NY, USA.
| | | | - Lucina Q Uddin
- University of California, Los Angeles, Los Angeles, CA, USA
| | - Liisa A M Galea
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Emily G Jacobs
- University of California, Santa Barbara, Santa Barbara, CA, USA
| | | | | | - M Mallar Chakravarty
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Cerebral Imaging Centre, Douglas Research Centre, Montreal, Quebec, Canada
| | - Avram J Holmes
- Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, NJ, USA
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Ginaldi L, De Martinis M. Who needs education on LGBTQIA+ healthcare inclusion? MEDICAL EDUCATION ONLINE 2024; 29:2329403. [PMID: 38484289 PMCID: PMC10946259 DOI: 10.1080/10872981.2024.2329403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
The topic of education on healthcare needs and equity of care for LGBTQIA+ populations is an extremely current issue. There is a demand for education on these topics not only from medical and other health sciences students but also from established healthcare professionals. Given this widespread educational deficiency, it is natural to ask whether the teaching class is prepared to satisfy these requests or in turn needs training on these issues and above all whether it is capable of transmitting attention and sensitivity on the issues of inclusion and equality in needs of healthcare.
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Affiliation(s)
- Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
- Long-Term Care Unit, “Maria SS. dello Splendore” Hospital, Giulianova, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- President bachelor’s degree in Nursing, “Teramo hub” University of L’Aquila, Teramo, Italy
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Azzellino G, Ginaldi L, De Martinis M. LGBTQIA+ populations still neglected in trials and their health needs. Gynecol Oncol 2024; 191:114-115. [PMID: 39388741 DOI: 10.1016/j.ygyno.2024.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 09/28/2024] [Accepted: 10/01/2024] [Indexed: 10/12/2024]
Affiliation(s)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy; Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy; Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova, AUSL 04 Teramo, Italy; Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
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Fortnum K, Gomersall SR, Ross MH, Woodforde J, Thomas G, Wen YS, Perales F, Stylianou M. 24-Hour Movement Behaviors of LGBTQA+ Young People: A Systematic Review. J Phys Act Health 2024; 21:1308-1324. [PMID: 39389567 DOI: 10.1123/jpah.2024-0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/11/2024] [Accepted: 08/18/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND The movement behaviors of LGBTQA+ young people, who encounter specific health, and other, challenges are not well understood. This systematic review examines the 24-hour movement behaviors of LGBTQA+ young people compared with population estimates of meeting the 24-hour movement guidelines. METHODS Seven electronic databases were searched from inception to January 2024. Observational studies published in English and reporting quantitative data for physical activity, sedentary behavior, or sleep duration for LGBTQA+ individuals <24 years old were included. Data were narratively synthesized for children/adolescents (<18 years) and young adults (18-24 years), guided by the Cochrane Synthesis Without Meta-analysis guidelines. RESULTS Fifty-six studies were included; 46 were of "fair" quality and 37 were conducted in the United States. Physical activity, sedentary behavior, and sleep outcomes were reported in 46, 11, and 14 studies, respectively. Ninety unique LGBTQA+ terms were identified. Based on outcomes reported in ≥1 study, and compared to population estimates, LGBTQA+ young people were less likely to meet aerobic physical activity and strength/resistance training guidelines. LGBTQA+ children/adolescents were less likely to meet the sleep guidelines. Young adults demonstrated similar adherence to sleep guidelines as population estimates. CONCLUSIONS Overall, our results suggest that LGBTQA+ young people have suboptimal 24-hour movement behaviors; in some cases, worse than population estimates. Utilization of more robust measures of exposure and outcome variables is recommended, with a focus on sleep and sedentary behavior.
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Affiliation(s)
- Kathryn Fortnum
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Center for Research Innovation (HWCRI), The University of Queensland, Brisbane, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Center for Research Innovation (HWCRI), The University of Queensland, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Megan H Ross
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - George Thomas
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Center for Research Innovation (HWCRI), The University of Queensland, Brisbane, QLD, Australia
| | - Yu-Shu Wen
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Center for Research Innovation (HWCRI), The University of Queensland, Brisbane, QLD, Australia
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, QLD, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
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Azzellino G, Ginaldi L, De Martinis M. The urgency of systematically acquiring sexual orientation and gender identity data to ensure equity of care. Cancer 2024; 130:3769-3770. [PMID: 39154221 DOI: 10.1002/cncr.35527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Affiliation(s)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, L'Aquila, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Technical Group for the Coordination of Gender Medicine, L'Aquila, Italy
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, AUSL 04 Teramo, Giulianova, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Roma, Italy
- President bachelor's degree in Nursing, "Teramo hub" University of L'Aquila, Teramo, Italy
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Azzellino G, Ginaldi L, De Martinis M. Renew the Nursing Profession to Attract New Forces and Be Increasingly Inclusive and Attentive to Diversity. J Adv Nurs 2024. [PMID: 39435601 DOI: 10.1111/jan.16552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 09/28/2024] [Accepted: 10/04/2024] [Indexed: 10/23/2024]
Affiliation(s)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Teramo, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova, AUSL 04 Teramo, Teramo, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- President bachelor's Degree in Nursing, "Teramo Hub" University of L'Aquila, Teramo, Italy
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Ginaldi L, Lelii S, Pinto ME, Trovato G, De Martinis M. Sexual orientation and gender identity (SOGI) and electronic health record data collection by national health systems to overcome disparities in healthcare. Intensive Crit Care Nurs 2024; 84:103699. [PMID: 38584050 DOI: 10.1016/j.iccn.2024.103699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy; Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Sara Lelii
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova AUSL 04, Teramo, Italy
| | - Maria Elena Pinto
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova AUSL 04, Teramo, Italy
| | - Giacomo Trovato
- Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova AUSL 04, Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Technical Group for the Coordination of Gender Medicine, Regione Abruzzo, Italy; Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova AUSL 04, Teramo, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy; President Bachelor's Degree in Nursing, "Teramo Hub" University of L'Aquila, Italy.
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