Incorporating health care concepts addressing the needs of the lesbian, gay, bisexual, and transgender population in an associate of science in nursing curriculum: Are faculty prepared?

The experiences of gender and sexually diverse parents using support and services for their young children: An integrative review

AIM

To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)?

DESIGN

Whittemore and Knafl's (2005) integrative review methodology.

METHODS

Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full-text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N-VIVO-12. Thematic content analysis was employed and PRISMA guidelines were adhered to.

RESULTS

A total of 18 articles (15 qualitative and three multi-method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences.

CONCLUSION

This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child.

IMPLICATIONS FOR THE PROFESSION

This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families.

IMPACT

Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well-being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences.

PATIENT OR PUBLIC CONTRIBUTION

Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review.

LGBTQI+ representation in pre-licensure nursing textbooks: A qualitative descriptive analysis

BACKGROUND

To improve health equity, nursing curricula should include content specific to the needs of marginalized and underserved communities, such as lesbian, gay, bisexual, transgender, queer, and intersex groups (LGBTQI+). Harmful and absent academic discussions of LGBTQI+ patients lead to provider discomfort and inadequacy in treating this patient population. Nursing schools are well-positioned to increase comfort with LGBTQI+ content as part of pre-licensure curricula. This article presents a systematic evaluation of LGBTQI+ content in nursing pre-licensure textbooks and the nature and quality of the representations.

METHODS

A qualitative descriptive analysis of LGBTQI+ content from 14 nursing-specific textbooks required by a pre-licensure degree program at the Johns Hopkins School of Nursing was conducted by a student-led team with faculty oversight. A priori and iterative search terms were used to identify and extract text segments that referenced LGBTQI+ content in each textbook. An iterative codebook was developed, codes were applied, and analysis of the information and context in which the terms were presented was performed.

RESULTS

The research team observed gaps and notable patterns in distribution of LGBTQI+ terms and health content areas across the textbooks reviewed. The majority of LGBTQI+ search terms were identified in the following health content areas: social determinants of health, sexual/reproductive health, pediatric sexual & gender diversity, intersectionality, and infectious disease. Based on qualitative descriptive analyses, the data were organized into the following categories: a) Language; b) Medicalization; c) Vague, Incomplete, or Lacking Specificity; and d) Comprehensive Approach.

CONCLUSION

Findings highlight the need for increased academic exposure for pre-licensure nursing students regarding the care of LGBTQI+ patients. Thoughtful inclusion of LGBTQI+ content may better foster the delivery of evidence-based care for this patient population. These findings underscore the need for improved nursing curricula to support nurses in delivering affirming care for LGBTQI+ populations.

The inclusion and representation of LGBTIQ+ content in undergraduate nurse education: A scoping review

OBJECTIVES

The aim of this review was to gain an overview of existing empirical literature examining LGBTIQ+ content in undergraduate nursing curricula.

DESIGN

An international scoping review was conducted using librarian assisted search strategies.

DATA SOURCES

The databases CINAHL, SCOPUS and ERIC were searched. A total of 30 studies meeting the eligibility criteria were included in this review.

REVIEW METHODS

Following a quality appraisal, thematic analysis was conducted to identify six key themes.

RESULTS

30 studies spanning 8 countries, across 5 continents were included in this review. 6 themes emerged 1) Level of Knowledge Regarding LGBTIQ+ People and Their Specific Health Needs, 2) Comfort and Preparedness in the Provision of Care to LGBTIQ+ People, 3) Attitudes Toward LGBTIQ+ People, 4) Inclusion of LGBTIQ+ Educational Content, 5) Framing of LGBTIQ+ Educational Content, 6) Pedagogical Strategies to Incorporate LGBTIQ+ Content.

CONCLUSIONS

Nurse education is dominated by heteronormativity, deficit discourses, stereotypes, binary ideologies and western cultural perspectives. The body of literature surrounding LGBTIQ+ content in nurse education is largely quantitative, insular and contributes to the erasure of unique identities under the LGBTIQ+ umbrella.

Pedagogical strategies of LGBTQIA+ education in pre-licensure nursing: An integrative review

OBJECTIVES

Previous research suggests that information about providing culturally sensitive care to patients of the LGBTQIA+ population has been lacking among pre-licensure nursing programs. This is due, in part, to a lack of faculty preparation and knowledge regarding LGBTQIA+ issues. The purpose of this integrative review is to examine pedagogical strategies of LGBTQIA+ content integration in pre-licensure nursing programs in the United States.

DATA SOURCES

The literature search was conducted by searching CINAHL, the Cochrane Database, PubMed, MEDLINE, Google Scholar, and PsychINFO for peer-reviewed articles that were written in the English language and completed in an educational setting.

REVIEW METHODS

The search was conducted by a single independent reviewer. Inclusion and exclusion criteria were applied to articles identified by the databases. Eighteen articles met all identified criteria. Articles were appraised using resources from the Joanna Briggs Institute and one article was excluded from further consideration after appraisal. Seventeen articles were analyzed for themes.

RESULTS

Three themes emerged from the review: lecture and dialogue, experiential learning, and reading and writing.

CONCLUSIONS

Based on the review of the literature, there is a myriad of evidence-based pedagogies to incorporate LGBTQIA+ content into pre-licensure nursing programs. Students were successful in achieving learning outcomes and interventions were well-received. The studies in this review may assist in mitigating a lack of faculty preparedness in teaching LGBTQIA+ content by providing examples of pedagogical strategies that can be adapted to fit their particular course or program.

"I don't feel like I'm a person": Nursing knowledge of transgender care through the lens of transgender people

AIMS

One aim of this study was to discover and understand the perceptions of healthcare delivery for transgender people who have had interactions with nurses while receiving care. An additional purpose of this study was to identify if these perceptions of nursing knowledge have an influence on transgender individuals seeking future healthcare.

DESIGN

Qualitative, interpretive description.

METHODS

Recruitment of participants and interviews took place between September and November 2020. Confidentiality and protection of human participants was prioritized, and data analysis concluded in early 2021.

RESULTS

Ten participant interviews were completed until data saturation were determined. One overarching theme and five supporting themes were constructed from data. Based on participant experiences, these themes reflect transgender peoples' perceptions of nursing knowledge of transgender care and how these perceptions impact seeking future healthcare.

CONCLUSION

Experiences that shaped transgender peoples' perceptions of nursing knowledge of transgender care varied depending on the locations of these services and the experience and understanding of registered nurses. These findings highlight the perceptions that transgender people have of registered nurses' knowledge of transgender care and the influence that those perceptions have on them seeking future healthcare.

Enfermeiros diante do cuidado à saúde de adolescentes gays

Resumo Objetivo: analisar narrativas de enfermeiros sobre o cuidado à saúde de adolescentes gays. Método: estudo qualitativo, ancorado na Análise Temática de Clarke e Braun, adotando como referencial teórico o Interacionismo Simbólico, uma vez que ele favorece a apreensão da relação de comportamentos, interações e significados sociais. Foram entrevistados remotamente 12 enfermeiros, recrutados a partir da técnica de bola de neve, por meio da plataforma de vídeo Google Meet ® . Resultados: ao longo do processo compreensivo-interpretativo, foram elaborados quatro temas: “Adolescente gay, pautas e relação com a saúde”; “A família do adolescente gay e o cuidado”; “Relação com adolescente gay no cuidado” e “Limites para o cuidar de enfermagem ao adolescente gay”. Conclusão: as narrativas denunciam estigmas e símbolos derivados da cisheteronormatividade como intervenientes da relação e indicam premência de apostas no encontro intersubjetivo com os adolescentes gays e seus familiares em relação horizontal, afetiva e empática, com chances de favorecer defesa pública do direito à saúde. Há apontamentos para a atitude dos enfermeiros e qualificação do cuidado a essa população.

Los enfermeros frente al cuidado de la salud de los adolescentes gays

Resumen Objetivo: analizar los relatos de los enfermeros sobre el cuidado de la salud de los adolescentes gays. Método: estudio cualitativo, anclado en el Análisis Temático de Clarke y Braun, adoptando el Interaccionismo Simbólico como marco teórico, ya que favorece la aprehensión de la relación de comportamientos, interacciones y significados sociales. Fueron entrevistados remotamente 12 enfermeros, reclutados a partir de la técnica de bola de nieve, por medio de la plataforma de video Google Meet ® . Resultados: a lo largo del proceso comprensivo-interpretativo, se elaboraron cuatro temas: “Adolescente gay, pautas y relación con la salud”; “La familia del adolescente gay y el cuidado”; “Relación con adolescente gay en el cuidado” y “Límites para el cuidado de enfermería al adolescente gay”. Conclusión: las narrativas denuncian los estigmas y símbolos derivados de la cisheteronormatividad como intervinientes de la relación e indican la urgencia de apuestas en el encuentro intersubjetivo con los adolescentes gays y sus familiares en relación horizontal, afectiva y empática, con posibilidades de favorecer la defensa pública del derecho a la salud. Hay apuntes para la actitud de los enfermeros y calificación del cuidado a esa población.

Nurses and health care for gay adolescents

Objective:

to analyze nurses’ statements about health care for gay adolescents.

Method:

qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet^® video-conferencing app.

Results:

four themes were elaborated throughout the comprehensive-interpretative process: “Gay adolescents, agendas, and relation with health;” “The gay adolescent’s family and care;” “Relationship with gay adolescents in care,” and “Limits to nursing care for gay adolescents.”

Conclusion:

the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses’ attitude and qualification of care for this population.

LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study

LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.