1
|
Loeb AJ, Crane SM, Wilkerson JM, Robison AJ, Johnson CM. Baby Boomer Gay Men's Experiences with Primary Healthcare. JOURNAL OF HOMOSEXUALITY 2024:1-24. [PMID: 38989973 DOI: 10.1080/00918369.2024.2366380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
This research explored baby boomer gay men's experiences with primary healthcare and their perspectives of future long-term care. Baby boomer gay men's perspectives about primary healthcare remain understudied in the United States. A descriptive qualitative study was conducted with 30 baby boomer men in the Southwest USA. We used semi-structured interviews to assess participants' initiation and maintenance of primary healthcare, disclosure of sexual orientation to providers, and perspectives about future healthcare needs, including long-term care. Data were analyzed with a latent thematic analysis. We found baby boomer gay men anticipate discrimination because of their sexual orientation whenever they establish healthcare with new providers. Participants identified circumstantial comfort in the new healthcare setting as a key motivator to disclose their sexual orientation. Thus, baby boomer gay men specifically sought gay or gay-friendly healthcare providers to ease the burden of managing disclosure and to permit free discussion of their sexual orientation and healthcare needs. Participants faced recurring anticipation of rejection and discrimination from healthcare providers, which extends to their perceptions of current healthcare encounters and future long-term care placement. Healthcare providers would benefit from understanding the practice implications of this dynamic. Future research on primary healthcare inclusivity is needed.
Collapse
Affiliation(s)
- Aaron J Loeb
- The University of Texas Health Science Center at Houston Cizik School of Nursing Houston, Houston, Texas, USA
| | - Stacey M Crane
- The University of Texas Health Science Center at Houston Cizik School of Nursing Houston, Houston, Texas, USA
| | - J Michael Wilkerson
- The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | | | - Constance M Johnson
- The University of Texas Health Science Center at Houston Cizik School of Nursing Houston, Houston, Texas, USA
| |
Collapse
|
2
|
Zazzera SK, Poole C, Marignol L. Investigating the Needs and Concerns of Lesbian, Gay, Bisexual, Transgender, Queer, or Questioning Cancer Patients. JOURNAL OF HOMOSEXUALITY 2024:1-29. [PMID: 38421298 DOI: 10.1080/00918369.2024.2321240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The needs and concerns of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) patients with cancer remain poorly understood. This is important as LGBTQ+ patients have an elevated risk of developing certain cancers and have poorer oncologic outcomes compared to non-LGBTQ+ patients. The lack of research may be linked to the complexity of studying the needs and concerns of this patient population. This review aimed to describe the evidence that sought to identify the needs and concerns of LGBTQ+ cancer patients. Studies were extracted using keywords such as "LGBTQ" and "Oncology." Patient participants were excluded if they did not identify as LGBTQ+ and if they did not have cancer or were not cancer survivors. Healthcare professionals were excluded if they were not oncology specific. A total of 22 studies met our inclusion criteria. LGBTQ+ cancer patients expressed concerns surrounding heteronormative assumptions made by healthcare professionals, a lack of LGBTQ±specific cancer support groups, and psychosexual concerns such as erectile dysfunction following cancer treatment. Oncology healthcare professionals lacked the knowledge and education that are required to manage this patient cohort. Further research is required to investigate the needs and concerns of LGBTQ+ cancer patients specifically in the radiation oncology setting.
Collapse
Affiliation(s)
- S K Zazzera
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College DublinUniversity of Dublin, Dublin, Ireland
| | - C Poole
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College DublinUniversity of Dublin, Dublin, Ireland
| | - L Marignol
- Applied Radiation Therapy Trinity (ARTT), Discipline of Radiation Therapy, School of Medicine, Trinity St. James's Cancer Institute, Trinity College DublinUniversity of Dublin, Dublin, Ireland
| |
Collapse
|
3
|
Berardi R, Rossi F, Papa R, Appetecchia M, Baggio G, Bianchini M, Mazzei T, Maria Moretti A, Ortona E, Pietrantonio F, Tarantino V, Vavalà T, Cinieri S. Gender oncology: recommendations and consensus of the Italian Association of Medical Oncology (AIOM). ESMO Open 2024; 9:102243. [PMID: 38394984 PMCID: PMC10937209 DOI: 10.1016/j.esmoop.2024.102243] [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: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Following the development of gender medicine in the past 20 years, more recently in the field of oncology an increasing amount of evidence suggests gender differences in the epidemiology of cancers, as well as in the response and toxicity associated with therapies. In a gender approach, critical issues related to sexual and gender minority (SGM) populations must also be considered. MATERIALS AND METHODS A working group of opinion leaders approved by the Italian Association of Medical Oncology (AIOM) has been set up with the aim of drafting a shared document on gender oncology. Through the 'consensus conference' method of the RAND/University of California Los Angeles (UCLA) variant, the members of the group evaluated statements partly from the scientific literature and partly produced by the experts themselves [good practice points (GPPs)], on the following topics: (i) Healthcare organisation, (ii) Therapy, (iii) Host factors, (iv) Cancer biology, and (v) Communication and social interventions. Finally, in support of each specific topic, they considered it appropriate to present some successful case studies. RESULTS A total of 42 articles met the inclusion criteria, from which 50 recommendations were extracted. Panel participants were given the opportunity to propose additional evidence from studies not included in the research results, from which 32 statements were extracted, and to make recommendations not derived from literature such as GPPs, four of which have been developed. After an evaluation of relevance by the panel, it was found that 81 recommendations scored >7, while 3 scored between 4 and 6.9, and 2 scored below 4. CONCLUSIONS This consensus and the document compiled thereafter represent an attempt to evaluate the available scientific evidence on the theme of gender oncology and to suggest standard criteria both for scientific research and for the care of patients in clinical practice that should take gender into account.
Collapse
Affiliation(s)
- R Berardi
- Medical Oncology, Polytechnic University of Marche Region, Ancona; Medical Oncology, AOU Marche, Ancona, Italy - National Councilor AIOM (Italian Association of Medical Oncology); Treasurer AIOM (Italian Association of Medical Oncology).
| | - F Rossi
- Medical Oncology, Polytechnic University of Marche Region, Ancona
| | - R Papa
- Quality, Risk Management and Health Technology Innovation Unit, Department of Staff, AOU Marche, Ancona
| | - M Appetecchia
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome
| | - G Baggio
- President of the Italian Research Center for Gender Health and Medicine, Chair of Gender Medicine 2012-2017, University of Padua, Padua
| | - M Bianchini
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome
| | - T Mazzei
- Department of Pharmacology, University of Florence, Florence
| | - A Maria Moretti
- National President of the Scientific Society GISeG (Italian Group Health and Gender); President of the International Society IGM (International Gender Medicine)
| | - E Ortona
- Head - Center for Gender-specific Medicine, Italian National Institute of Health, Rome
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - V Tarantino
- Medical Oncology, Polytechnic University of Marche Region, Ancona
| | - T Vavalà
- SC of Oncology 1U, Department of Oncology, AOU Città della Salute e della Scienza, Torino; AIOM (Italian Association of Medical Oncology); GISeG (Italian Group Health and Gender)
| | - S Cinieri
- Medical Oncology and Breast Unit, Perrino Hospital, Brindisi; President of AIOM Foundation (Italian Association of Medical Oncology), Italy
| |
Collapse
|
4
|
Burnett C, Lyerly R, Jesdale BM. Overall Satisfaction with Cancer Care Among Sexual and Gender Minority People and Their Utilization of Identity-Tailored Health Education Materials. LGBT Health 2024. [PMID: 38294770 DOI: 10.1089/lgbt.2023.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Purpose: This study was conducted to understand whether health education materials made specifically for members of sexual and gender minority (SGM) groups play a pivotal role in SGM cancer survivors' care satisfaction and experiences. Methods: We identified 2250 SGM cancer survivors who completed the "OUT: National Cancer Survey," conducted by the National LGBT Cancer Network in 2020-2021, and classified participants by their self-reported satisfaction with overall cancer care. We examined care satisfaction in relation to use of SGM-tailored health education resources and factors surrounding their SGM identities, which may influence their satisfaction, including feelings of safety with care teams. Results: Regardless of satisfaction with overall care, substantial proportions of survivors reported lacking vital health education resources specific to their SGM identities in areas of mental health (69%), physical activity (91%), tobacco use cessation (89%), and alcohol consumption (86%), despite attributing value to these materials. Contextualizing SGM survivor satisfaction with care, it was notable that among SGM survivors who felt safe with members of their care team knowing their SGM identity, only 3% were less than satisfied with their overall cancer care, compared to 38% who felt unsafe. Conclusion: SGM survivors value tailored information and health education resources that incorporate their intersectional identities. More research must be done to elucidate why SGM survivors do not receive these materials, while creating spaces where they feel safe receiving care. Increased delivery of SGM-tailored materials and prioritization of SGM safety in health care may have implications for overall cancer care satisfaction among SGM survivors.
Collapse
Affiliation(s)
- Colin Burnett
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Reece Lyerly
- National LGBT Cancer Network, Providence, Rhode Island, USA
| | - Bill M Jesdale
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
5
|
Aburizik A, Raque TL, Spitz N, Mott SL, McEnroe A, Kivlighan M. Responding to distress in cancer care: Increasing access to psycho oncology services through integrated collaborative care. Psychooncology 2023; 32:1675-1683. [PMID: 37724636 DOI: 10.1002/pon.6217] [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: 03/27/2023] [Revised: 08/15/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE Despite increased attention to the utility of collaborative care models for promoting whole-person care in cancer populations, there is a paucity of empirical research testing the impact of these care models on effectively identifying and serving highly distressed cancer patients. This study sought to experimentally test the effectiveness of a year-long collaborative care program on referral rates to psycho-oncology services for patients with moderate to high distress. METHODS Data for this study consisted of 11,467 adult patients with cancer who were screened for psychosocial distress 6-months prior to, and following, the integrated collaborative care intervention. Psychosocial referral rates pre-, peri- and post- intervention were analyzed. RESULTS Findings indicated high distress patients were at 3.76 (95% CI [2.40, 5.87]), 5.03 (95% CI [3.25, 7.76]), and 7.62 (95% CI [5.34, 10.87]) times increased odds of being referred during the pre-intervention, peri-intervention, and post-intervention, respectively, when compared to low distress patients, and these differences across time were significantly different (p = 0.04). CONCLUSION Findings from this study suggest that the successful initiation of a collaborative care model within a comprehensive cancer center contributed to significantly greater referral rates of cancer patients with moderate to high distress to psycho-oncology services. This study contributes to the growing consensus that collaborative care models can positively impact the care of complex medical patients.
Collapse
Affiliation(s)
- Arwa Aburizik
- Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Trisha L Raque
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Nathen Spitz
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Aubrey McEnroe
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, Iowa, USA
| | - Martin Kivlighan
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
6
|
Smart AC, Liu KX, Domogauer JD, Rodriguez-Russo C, Jones B, Dickstein DR, Mancias JD, Shiloh RY, Wintner A, Zietman AL, Marshall DC, Dyer MA, Russo AL. Gender-Affirming Surgery and Cancer: Considerations for Radiation Oncologists for Pelvic Radiation in Transfeminine Patients. Int J Radiat Oncol Biol Phys 2023; 117:301-311. [PMID: 37230432 PMCID: PMC10527783 DOI: 10.1016/j.ijrobp.2023.05.028] [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: 03/20/2023] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023]
Abstract
Access to gender-affirming surgery is increasing for many transgender and nonbinary people in the United States, and radiation oncologists must be equipped to care for patients who have undergone such surgery in the region of their planned radiation treatment field. There are no guidelines for radiation treatment planning after gender-affirming surgery, and most oncologists do not receive training in the unique needs of transgender people with cancer. We review common gender-affirming genitopelvic surgeries for transfeminine people, including vaginoplasty, labiaplasty, and orchiectomy, and summarize the existing literature on the treatment of cancers of the neovagina, anus, rectum, prostate, and bladder in these patients. We also describe our systematic treatment approach and rationale for pelvic radiation treatment planning.
Collapse
Affiliation(s)
- Alicia C Smart
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
| | - Kevin X Liu
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jason D Domogauer
- Department of Radiation Oncology, New York University Langone Health, New York University, New York, New York
| | - Carlos Rodriguez-Russo
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brianna Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph D Mancias
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Ron Y Shiloh
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Anton Wintner
- Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Anthony L Zietman
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - M Aiven Dyer
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Andrea L Russo
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|
7
|
Mansur A, Kempf AM, Bitterman DS, Patel CG, Dyer MA, Haas-Kogan DA, Liu KX, Smart AC. Clinical outcomes of radiation therapy for transgender and gender-expansive people with cancer. Front Oncol 2023; 13:1135400. [PMID: 37746299 PMCID: PMC10517178 DOI: 10.3389/fonc.2023.1135400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/11/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Approximately 1.6 million people in the US identify as transgender, many of whom undergo gender-affirming medical or surgical therapies. While transgender individuals are diagnosed with cancer at similar rates as those who are cisgender, the impacts of radiation therapy on outcomes of gender-affirming care in transgender, nonbinary, and gender-expansive people with cancer are understudied. We report on the experiences and outcomes of transgender and gender-expansive patients receiving radiation therapy for cancer treatment. Methods This study is a multi-institutional retrospective review of patients evaluated from 2005-2019 identified as transgender or gender-expansive in the medical record and treated with radiation therapy. Results We identified 23 patients who received radiation to 32 sites, including 12 (38%) to the brain, head, or neck, 8 (25%) to the thorax, and 7 (22%) to the pelvis. Seventeen patients (74%) received gender-affirming hormone therapy and 13 patients (57%) underwent gender-affirming surgery. Four patients had pelvic radiation before or after gender-affirming pelvic surgery, including two trans women who had pelvic radiation after vaginoplasty. Four patients had radiation to the chest or thorax and gender-affirming chest or breast surgery, including two trans men with breast cancer. Two pediatric patients developed hypopituitarism and hypogonadism secondary to radiation therapy and, as adults, changed their hormone replacement therapy to affirm their transgender identities. Discussion Transgender people with cancer undergo radiation therapy for a wide range of cancers. Understanding their prior gender-affirming medical or surgical treatments and future gender affirmation goals may identify important considerations for their oncologic care.
Collapse
Affiliation(s)
- Arian Mansur
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Abigail M. Kempf
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Danielle S. Bitterman
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Chirayu G. Patel
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States
| | - M Aiven Dyer
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Daphne A. Haas-Kogan
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Radiation Oncology, Boston Children’s Hospital, Boston, MA, United States
| | - Kevin X. Liu
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiation Oncology, Boston Children’s Hospital, Boston, MA, United States
| | - Alicia C. Smart
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiation Oncology, Boston Children’s Hospital, Boston, MA, United States
| |
Collapse
|
8
|
Ussher JM, Quinn GP, Perz J. Editorial: Cancer prevention, treatment and survivorship in the LGBTQIA community. Front Oncol 2023; 13:1227911. [PMID: 37496659 PMCID: PMC10368242 DOI: 10.3389/fonc.2023.1227911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023] Open
Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology and Population Health, New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|
9
|
Ussher JM, Ryan S, Power R, Perz J. Almost invisible: A review of inclusion of LGBTQI people with cancer in online patient information resources. PATIENT EDUCATION AND COUNSELING 2023; 114:107846. [PMID: 37331279 DOI: 10.1016/j.pec.2023.107846] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE This review assessed the inclusion of lesbian, gay, bisexual, trans, queer and/or intersex (LGBTQI) people in online cancer information. METHODS The websites of Australian cancer organizations were reviewed to identify if they included LGBTQI people and the extent and nature of this inclusion. Websites that did not include LGBTQI people were then reviewed to identify if information was implicitly LGBTQI inclusive. International LGBTQI cancer information resources were reviewed to identify key content. RESULTS Of sixty-one Australian cancer organization websites reviewed, eight (13%) mentioned LGBTQI people, including 13 information resources targeted to LGBTQI people and 19 general cancer information resources that mentioned LGBTQI people. For Australian cancer websites that did not mention LGBTQI people, 88% used gender neutral language to refer to partners, 69% included a range of sexual behaviours, 13% used gender neutral language when referring to hormones or reproductive anatomy but none acknowledged diverse relationship types. Internationally, 38 LGBTQI-specific cancer information resources were identified. CONCLUSIONS Cancer patient information resources need to be LGBTQI inclusive. LGBTQI-targeted resources are required to address this population's unique needs and improve cultural safety and cancer outcomes. PRACTICE IMPLICATIONS Recommendations are provided for LGBTQI inclusive cancer patient information resources.
Collapse
Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South 2751, Australia.
| | - Samantha Ryan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South 2751, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South 2751, Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South 2751, Australia
| |
Collapse
|
10
|
Kano M, Tamí-Maury I, Pratt-Chapman ML, Chang S, Kosich M, Quinn GP, Poteat T, Kanetsky PA, Elk R, Boehmer U, Sanchez J, Kamen C, Sanchez NF. Piloting the Sexual and Gender Minority Cancer Curricular Advances for Research and Education (SGM Cancer CARE) Workshop: Research Training in the Service of SGM Cancer Health Equity. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1066-1076. [PMID: 36399283 PMCID: PMC9673892 DOI: 10.1007/s13187-022-02233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 06/02/2023]
Abstract
The purpose of this study is to describe the context, curriculum design, and pilot evaluation of the educational program "Sexual and Gender Minority Cancer Curricular Advances for Research and Education" (SGM Cancer CARE), a workshop for early-career researchers and healthcare providers interested in gaining knowledge and skills in sexual and gender minority (SGM) cancer research and healthcare advocacy. A needs assessment of a sample of clinicians and researchers (n = 104) and feedback from an Advisory Board informed the curriculum design of the SGM Cancer CARE workshop. Four SGM-tailored modules, focusing on epidemiology, clinical research, behavioral science and interventions, and community-based participatory approaches, were developed and tested in a 2.5-day virtual format among 19 clinicians and researchers. A fifth module to provide feedback to participants on brief presentations about their SGM cancer research ideas or related efforts was added later. A mixed-methods evaluation comprised of pre- and post-modular online evaluation surveys and virtual focus groups was used to determine the degree to which the workshop curriculum met participant needs. Compared to pre-module evaluations, participants reported a marked increase in SGM cancer research knowledge in post-module scores. Quantitative results were supported by our qualitative findings. In open field response survey questions and post-workshop focus groups, participants reported being extremely pleased with the content and delivery format of the SGM Cancer CARE workshop. Participants did regret not having the opportunity to connect with instructors, mentors, and colleagues in person. The SGM Cancer CARE curriculum was shown to increase the knowledge, skills, and level of preparedness of early-career clinicians and scientists to conduct culturally relevant and appropriate research needed to improve care for SGM persons across the cancer care continuum from prevention to survivorship.
Collapse
Affiliation(s)
- Miria Kano
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Science Center, Albuquerque, NM, USA.
| | - Irene Tamí-Maury
- Department of Epidemiology, School of Public Health, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Mandi L Pratt-Chapman
- Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Shine Chang
- Division of Cancer Prevention and Population Sciences, Department of Epidemiology and Cancer Prevention Research Training Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mikaela Kosich
- Biostatistics Shared Resource, The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Gwendolyn P Quinn
- Department of OBGYN, Perlmutter Cancer Center, Grossman School of Medicine, New York University, New York, NY, USA
| | - Tonia Poteat
- Department of Social Medicine, Lineberger Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ronit Elk
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Julian Sanchez
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Charles Kamen
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Nelson F Sanchez
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
11
|
Sampson A, Block R, Lake PW, Gagliardi J, Augusto B, Santiago-Datil W, Sutter M, Schabath MB, Vadaparampil S, Quinn GP. "No one size fits all" A Multi-Method Survey of Oncology Allied Health Professionals Experiences with Lesbian, Gay, Bisexual, Transgender/Queer Questioning Adolescent, and Young Adult Patients with Cancer and Reproductive and Sexual Health". J Adolesc Young Adult Oncol 2023; 12:250-258. [PMID: 35731000 PMCID: PMC10124174 DOI: 10.1089/jayao.2021.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess training needs for providers who care for adolescent and young adult (AYA) lesbian, gay, bisexual, transgender/queer questioning (LGBTQ) cancer patients, we conducted a mixed-method survey. During their cancer care experience, AYA cancer patients experience physical, psychosocial, and reproductive health challenges. In addition to these challenges, AYA LGBTQ individuals are a diverse and medically underserved population who experience unique challenges and disparities in medical care. Methods: Health care providers (n = 351) who participated in our reproductive health in cancer training program completed a survey with 28 quantitative items and 4 open-ended items assessing knowledge, confidence discussing reproductive health, and confidence in knowledge specific to reproductive needs and general health needs among AYA LGBTQ patients. Results: Confidence discussing and confidence in knowledge of reproductive and general health needs are lower regarding transgender and nonbinary patients. Nearly half of providers (45%) demonstrated low knowledge, while 38% and 17% demonstrated moderate and high knowledge, respectively. Open comments indicated providers desired more training around the needs of Trans and nonbinary patients, and creating welcoming environments. Conclusions: The majority of our participants demonstrate low or moderate knowledge regarding factors that can influence AYA LGBTQ patient care, suggesting that this is a key area for improvement. Furthermore, improving provider knowledge may subsequently improve confidence in general and reproductive needs of LGBTQ patients, resulting in improved patient-centered care. Improving provider knowledge and confidence may then ultimately help reduce disparities in cancer care among this patient population.
Collapse
Affiliation(s)
- Amani Sampson
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | | | - Paige W. Lake
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Julia Gagliardi
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Bianca Augusto
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Waleska Santiago-Datil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Megan Sutter
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Matthew B. Schabath
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Susan Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
12
|
Schulz-Quach C, Kennedy M, Lyver B. Sexual and gender diversity in cancer care and survivorship. Curr Opin Support Palliat Care 2023; 17:55-69. [PMID: 36656606 DOI: 10.1097/spc.0000000000000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF THE REVIEW Sexual and gender diverse (SGD) cancer patients possess unique identities and needs that must be considered during their cancer care. This narrative review explores the current literature on sexual and gender diversity in cancer care and survivorship, in addition to providing recommendations encouraged by the current literature. RECENT FINDINGS We performed a literature search for articles published in English between January 2021 and June 2022 in Medline ALL and Embase. Fifty-two studies were included in this review. The many identities encapsulated in 2SLGBTQIA+ (2 Spirited, Lesbian, Gay, Bisexual, Transgender, Queer, Intersexual, Asexual, Agender, Aromantic and all gender identities and sexual orientations that are not listed) communities each have their own unique backgrounds, needs and disparities in cancer care and survivorship. However, we also identified specific protective factors in the cancer experience of SGD patients such as reports of higher resiliency and stronger support networks. Much of the recent research features recommendations on improving cancer care by creating inclusive patient questionnaires, improving in-person and online resources, and educating healthcare providers and patient-facing staff on inclusive care. SUMMARY SGD patients have their own specific challenges during and following their cancer care. As the research continues to grow, we gain a better understanding of the needs of these patients and future steps to take to improve SGD patients' cancer experience.
Collapse
Affiliation(s)
- Christian Schulz-Quach
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
- Centre of Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Margo Kennedy
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
| | - Brendan Lyver
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
| |
Collapse
|
13
|
Association of Affirming Care with Chronic Disease and Preventive Care Outcomes among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults. Am J Prev Med 2023; 64:305-314. [PMID: 36460525 DOI: 10.1016/j.amepre.2022.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Experiences of discrimination and bias in healthcare contribute to health disparities for lesbian, gay, bisexual, transgender, and queer populations. To avoid discrimination, many go to great lengths to find healthcare providers who they trust and who are knowledgeable about their health needs. This study examines whether access to an affirming provider improves health outcomes for lesbian, gay, bisexual, transgender, and queer populations across a range of preventive health and chronic disease management outcomes. METHODS This cross-sectional study uses Poisson regression models to examine original survey data (n=1,120) from Wave 1 of the Vanderbilt University Social Networks, Aging, and Policy Study, a panel study examining older (aged 50-76 years) lesbian, gay, bisexual, transgender, and queer adults' health and aging, collected between April 2020 and September 2021. RESULTS Overall, access to an affirming provider is associated with greater uptake of preventive health screenings and improved management of mental health conditions. Participants with an affirming provider are more likely to have ever and recently received several types of preventive care than participants reporting a usual source of care that is not affirming, including past year provider visit, influenza vaccination, colorectal cancer screening, and HIV test. Access to an affirming provider is also associated with better management of mental health conditions. CONCLUSIONS Inclusive care is essential for reducing health disparities among lesbian, gay, bisexual, transgender, and queer populations. Health systems can reduce disparities by expanding continuing education opportunities; adopting nondiscrimination policies for patients and employees; and ensuring that necessary care is covered by health insurance.
Collapse
|
14
|
Jivraj N, Shapiro GK, Schulz-Quach C, Van de Laar E, Liu ZA, Weiss J, Croke J. Evaluating Healthcare Professionals' Knowledge, Attitudes, Practices and Education Interest in LGBTQ2 + Cancer Care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022:10.1007/s13187-022-02244-x. [PMID: 36454364 DOI: 10.1007/s13187-022-02244-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
The lesbian, gay, bisexual, transgender, queer/questioning and two-spirited, plus (LGBTQ2 +) community experiences cancer-related health disparities and inequities. Our objective was to assess LGBTQ2 + knowledge, attitudes, practices and education interest of healthcare professionals (HCPs), identify opportunities to improve care and inform the development of an HCP education curriculum. This was a mixed methods quality improvement study conducted within a tertiary academic cancer centre. An email was sent to all gynaecologic oncology disease site staff (n = 92) with a secure link to an online survey. We measured respondents' sociodemographic characteristics and LGBTQ2 + knowledge, attitudes, practice behaviours and education interest. Open comments explored HCP experiences and reservations caring for LGBTQ2 + patients and suggestions to improve care. Seventy-five out of ninety-two (82%) HCPs completed the survey, with 7% identifying as LGBTQ2 + . HCPs reported feeling less comfortable (88% vs. 80%, p = 0.031) and knowledgeable (44% vs. 27%, p < 0.001) caring for transgender patients compared to LGBQ2 + patients. Most (76%) were unaware whether LGBTQ2 + -specific patient educational materials existed within their institution. Almost all (92% strongly agreed/agreed) were interested in receiving LGBTQ2 + -specific education. Two themes emerged from analysis of open comments: (i) HCPs are concerned of offending LGBTQ2 + individuals because of their lack of knowledge and (ii) HCPs desire LGBTQ2 + -specific health training, specifically in asking pronouns and caring for transgender patients. HCPs report competency gaps in caring for LGBTQ2 + patients with cancer but desire education. In response, we recommend institutions develop an educational curriculum for HCPs improve communication and inclusivity in cancer care.
Collapse
Affiliation(s)
- Nazlin Jivraj
- Gynecology Oncology Ambulatory Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Gilla K Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Palliative and End-of-Life Care (GIPPEC), Global Institute of Psychosocial, University of Toronto, Toronto, ON, Canada
| | - Christian Schulz-Quach
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emily Van de Laar
- Division of Gynecologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Zhihui Amy Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jessica Weiss
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jennifer Croke
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
| |
Collapse
|
15
|
Block RG, Sampson A, Gagliardi J, Augusto B, Santiago-Datil W, Schabath MB, Vadaparampil ST, Quinn GP. The LOvE ECHO Training: Developing a Web-Based LGBTQ Cultural Competency Training Module for Oncology Allied Health Professionals. J Adolesc Young Adult Oncol 2022; 11:556-563. [PMID: 35475655 PMCID: PMC9784593 DOI: 10.1089/jayao.2021.0159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose: This article describes the development of the LGBTQ Oncofertility Education (LOvE-ECHO). The Enriching Communication skills for Health professionals in Oncofertility (ECHO) team created this new education module in response to the needs of oncology allied health professionals to provide inclusive and affirming care to lesbian, gay, bisexual, transgender, and queer (LGBTQ) AYA patients with cancer. The new module is part of the ECHO, a web-based educational training program for oncology allied health professionals to improve communication with AYA about reproductive health. Methods: The development of LOvE-ECHO includes five phases-learner needs assessment, content development and revision, piloting, and finalizing. Results from a survey of past ECHO learners and a comprehensive literature review provided the basis of need for this module and identified the most prominent gaps in knowledge and training. Content development and revision were iterative, including input, feedback, and voices from LQBTA youth and survivors, researchers, reproductive health experts, oncology clinicians, and web developer. Results: The complete LOvE-ECHO module consists of both didactic and interactive lessons. A glossary of terms and narrated PowerPoint establishes a knowledge base and shared vocabulary. Three interactive cases and a plan for action provide learners opportunities to test their new knowledge and transfer it to their practice. Conclusion: The module has received positive feedback to date. It is currently being piloted with new learners who complete a pre-test and post-test, as well as a feedback survey. Analysis of these results will inform revisions to the module.
Collapse
Affiliation(s)
| | - Amani Sampson
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Julia Gagliardi
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Bianca Augusto
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Waleska Santiago-Datil
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, and and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Susan T. Vadaparampil
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
- Departments of Population Health and Perlmutter Cancer Center, New York, New York, USA
| |
Collapse
|
16
|
Ketcher D, Reblin M, Mansfield KJ, McCormick R, Skinner AM, Otto AK, Tennant K, Wawrzynski SE, Reed DR, Cloyes KG. "It's Kind of Complicated": A Qualitative Exploration of Perceived Social Support in Young Adult and Young Adult Lesbian, Gay, Bisexual, Transgender, and/or Queer Cancer Survivors. J Adolesc Young Adult Oncol 2022; 11:564-570. [PMID: 35166594 PMCID: PMC9784592 DOI: 10.1089/jayao.2021.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose: This qualitative secondary analysis describes the perceived importance of familial, peer, and health system social support for an understudied group of cancer survivors: young adults (YAs), including those who are lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). Methods: Semistructured interviews were conducted with YA cancer survivors as part of a study of social support networks and interactions. Team members conducted content analysis of interview transcripts; coding decisions were reviewed and discussed among the research team. Descriptions of social support were ultimately organized around family, peer, and health care system support. Results: Twelve YA survivors recruited using two National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and social media participated between August 2019 and May 2020. Survivors averaged 28.2 years old. Half of survivors self-identified as female; four survivors were LGBTQ. Participants described both the positives of social support, as well as barriers to meeting support needs, within the following three levels: familial, peer, and health care providers or system. Conclusion: YA survivors have needs that are often addressed by their families, peers, and the health care system. However, barriers such as complex relationship history and lack of targeted/tailored support programs can prevent survivors from receiving adequate support. The growing diversity and intersectionality represented in the YA population call for targeted support and training by the health care system to sufficiently support this population.
Collapse
Affiliation(s)
- Dana Ketcher
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | | | - Rachael McCormick
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Amber M. Skinner
- Adolescent Young Adult Program, Moffitt Cancer Center, Tampa, Florida, USA
| | - Amy K. Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Karrin Tennant
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Damon R. Reed
- Adolescent Young Adult Program, Moffitt Cancer Center, Tampa, Florida, USA
| | | |
Collapse
|
17
|
Chan ASW, Leung LM, Li JSF, Ho JMC, Tam HL, Hsu WL, Iu ANOS, Tang PMK, Yan E. Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis. Front Public Health 2022; 10:912980. [PMID: 36523575 PMCID: PMC9746694 DOI: 10.3389/fpubh.2022.912980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing. Objective The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing. Methods This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse. Results The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1). Conclusion Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.
Collapse
Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,*Correspondence: Alex Siu Wing Chan ;
| | - Lok Man Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jane Siu Fan Li
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jacqueline Mei Chi Ho
- Faculty of Health and Social Sciences, School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Hon Lon Tam
- Faculty of Medicine, Nethersole School of Nursing, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wing Leung Hsu
- Aceso Medical Centre, Hong Kong, Hong Kong SAR, China,Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, United Kingdom
| | - April Nicole On Sang Iu
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Patrick Ming Kuen Tang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Elsie Yan
| | - Elsie Yan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,Patrick Ming Kuen Tang
| |
Collapse
|
18
|
Ussher JM, Allison K, Perz J, Power R. LGBTQI cancer patients' quality of life and distress: A comparison by gender, sexuality, age, cancer type and geographical remoteness. Front Oncol 2022; 12:873642. [PMID: 36203463 PMCID: PMC9530284 DOI: 10.3389/fonc.2022.873642] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background There is growing acknowledgement of the psycho-social vulnerability of lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) people with cancer. The majority of research to date has focused on cisgender adults with breast or prostate cancer. Study Aim This study examined psycho-social factors associated with distress and quality of life for LGBTQI cancer patients and survivors, across a range of sexualities and gender identities, intersex status, tumor types, ages and urban/rural/remote location using an intersectional theoretical framework. Method 430 LGBTQI people with cancer completed an online survey, measuring distress, quality of life (QOL), and a range of psycho-social variables. Participants included 216 (50.2%) cisgender women, 145 (33.7%) cisgender men, and 63 (14.7%) transgender and gender diverse (TGD) people. Thirty-one (7.2%) participants reported intersex variation and 90 (20%) were adolescents or young adults (AYA), aged 15-39. The majority lived in urban areas (54.4%) and identified as lesbian, gay or bisexual (73.7%), with 10.9% identifying as bisexual, and 10.5% as queer, including reproductive (32.4%) and non-reproductive (67.6%) cancers. Results Forty-one percent of participants reported high or very high distress levels, 3-6 times higher than previous non-LGBTQI cancer studies. Higher rates of distress and lower QOL were identified in TGD compared to cisgender people, AYAs compared to older people, those who identify as bisexual or queer, compared to those who identify as lesbian, gay or homosexual, and those who live in rural or regional areas, compared to urban areas. Elevated distress and lower QOL was associated with greater minority stress (discrimination in life and in cancer care, discomfort being LGBTQI, lower outness) and lower social support, in these subgroups. There were no differences between reproductive and non-reproductive cancers. For the whole sample, distress and poor QOL were associated with physical and sexual concerns, the impact of cancer on gender and LGBTQI identities, minority stress, and lack of social support. Conclusion LGBTQI people with cancer are at high risk of distress and impaired QOL. Research and oncology healthcare practice needs to recognize the diversity of LGBTQI communities, and the ways in which minority stress and lack of social support may affect wellbeing.
Collapse
|
19
|
Westwood S. Religious-based negative attitudes towards LGBTQ people among healthcare, social care and social work students and professionals: A review of the international literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1449-e1470. [PMID: 35396881 PMCID: PMC9543796 DOI: 10.1111/hsc.13812] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/07/2022] [Accepted: 03/29/2022] [Indexed: 05/27/2023]
Abstract
There is a dearth of research on how negative religious attitudes towards LGBTQ people inform professional practice. This paper reports on a scoping review of 70 selected studies from 25 different countries. It explores key issues and knowledge gaps regarding the delivery of services to LGBTQ adults by religious healthcare, social care and social work organisations and/or practitioners with faith-based objections to LGBTQ people and their lives. The review identified four main themes: (1) a close connection between religious affiliation and negative attitudes towards LGBTQ people, among both students and professionals; (2) a heightening effect of religiosity, particularly among Christian and Muslim practitioners/students; (3) educators' religious attitudes informing curriculum design and delivery, and some highly religious students resisting and/or feeling oppressed by LGBTQ-inclusivity, if present; (4) examples of practice concerns raised by professionals and lay LGBTQ people. The article considers the ethical, practical, educational and professional standards implications, highlighting the need for further research in this area.
Collapse
|
20
|
Tamargo CL, Mitchell EP, Wagner L, Simon MA, Carlos RC, Giantonio BJ, Schabath MB, Quinn GP. “I need more knowledge”: Qualitative analysis of oncology providers’ experiences with sexual and gender minority patients. Front Psychol 2022; 13:763348. [PMID: 36046410 PMCID: PMC9421156 DOI: 10.3389/fpsyg.2022.763348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background While societal acceptance for sexual and gender minority (SGM) individuals is increasing, this group continues to face barriers to quality healthcare. Little is known about clinicians’ experiences with SGM patients in the oncology setting. To address this, a mixed method survey was administered to members of the ECOG-ACRIN Cancer Research Group. Materials and methods We report results from the open-ended portion of the survey. Four questions asked clinicians to describe experiences with SGM patients, reservations in caring for them, suggestions for improvement in SGM cancer care, and additional comments. Data were analyzed using content analysis and the constant comparison method. Results The majority of respondents noted they had no or little familiarity with SGM patients. A minority of respondents noted experience with gay and lesbian patients, but not transgender patients; many who reported experience with transgender patients also noted difficulty navigating the correct use of pronouns. Many respondents also highlighted positive experiences with SGM patients. Suggestions for improvement in SGM cancer care included providing widespread training, attending to unique end-of-life care issues among SGM patients, and engaging in efforts to build trust. Conclusion Clinicians have minimal experiences with SGM patients with cancer but desire training. Training the entire workforce may improve trust with, outreach efforts to, and cancer care delivery to the SGM community.
Collapse
Affiliation(s)
- Christina L. Tamargo
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Edith P. Mitchell
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, NC, United States
| | - Melissa A. Simon
- Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ruth C. Carlos
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Bruce J. Giantonio
- Department of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, United States
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
- *Correspondence: Matthew B. Schabath,
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology and Population Health, NYU Grossman School of Medicine, New York, NY, United States
| |
Collapse
|
21
|
Ussher JM, Perz J, Allison K, Power R, Hawkey A, Dowsett GW, Hickey M, Parton C, McDonald FEJ, Davis ID, Quinn GP, Boydell K, Robinson KH, Chambers S, Anazodo A. Attitudes, knowledge and practice behaviours of oncology health care professionals towards lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) patients and their carers: A mixed-methods study. PATIENT EDUCATION AND COUNSELING 2022; 105:2512-2523. [PMID: 34998663 DOI: 10.1016/j.pec.2021.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/21/2021] [Accepted: 12/11/2021] [Indexed: 05/25/2023]
Abstract
OBJECTIVE There is growing recognition that health care professionals (HCPs) and policy makers are insufficiently equipped to provide culturally competent care to lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) cancer patients and their families. We examined HCP attitudes, knowledge, and practices regarding LGBTQI cancer care using a mixed-methods research design. METHOD Surveys were completed by 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%), and clinical leadership roles (11%); 48 of the surveyed HCPs were interviewed. RESULTS Most HCPs reported being comfortable treating LGBTQI patients, but reported low levels of confidence and knowledge and systemic barriers to LGBTQI cancer care. Most wanted more education and training, particularly on trans and gender-diverse people (TGD) and those born with intersex variations. CONCLUSION Education of HCPs and health system changes are required to overcome barriers to the provision of culturally competent cancer care for LGBTQI patients. PRACTICE IMPLICATIONS These findings reinforce the need for inclusion of LGBTQI content in HCP education and professional training curricula, and institutional support for LGBTQI-inclusive practice behaviours. This includes administrative and visual cues to signal safety of LGBTQI patients within cancer care, facilitating inclusive environments, and the provision of tailored patient-centred care.
Collapse
Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Alexandra Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Melbourne, Australia
| | - Chloe Parton
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Fiona E J McDonald
- Canteen and Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ian D Davis
- Eastern Health Clinical School, Monash University and Eastern Health, Melbourne, Australia
| | - Gwendolyn P Quinn
- Departments of OB-GYN, Population Health, Grossman School of Medicine, New York University, NY, USA
| | - Katherine Boydell
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Kerry H Robinson
- School of Social Sciences and Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital and School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
22
|
Gannon T, Phillips B, Saunders D, Berner AM. Knowing to Ask and Feeling Safe to Tell - Understanding the Influences of HCP-Patient Interactions in Cancer Care for LGBTQ+ Children and Young People. Front Oncol 2022; 12:891874. [PMID: 35814480 PMCID: PMC9263369 DOI: 10.3389/fonc.2022.891874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) people experience healthcare inequalities in cancer care. Previous studies have focused on knowledge, attitudes and behaviours of healthcare professionals (HCPs) treating adults with cancer and how these contribute to inequalities. To date, no research has focused on HCPs treating LGBTQ+ children and adolescents with cancer in the UK. This is important given that this group may be at a critical time for exploring their gender identity and sexual orientation, whilst also facing a cancer diagnosis. We aimed to explore the knowledge, attitudes and behaviours of paediatric, teenage and young adult oncology HCPs treating LGBTQ+ patients in the UK. Methods We carried out semi-structured interviews with 8 HCPs in paediatric, teenage and young adult (TYA) oncology from the Royal Marsden NHS Foundation Trust. Eight questions were asked, which centred around participants' knowledge, attitudes and behaviours regarding management of LGBTQ+ patients in oncology. Interview transcripts were analysed by inductive thematic analysis. Results We identified 10 themes, including novel themes (how HCPs acquire knowledge and expectations of a 'third party' to be the expert) which may underlie previously observed trends in knowledge, attitudes and behaviours of HCPs. We highlight other themes and HCP concerns specific to care of LGBTQ+ patients in paediatrics (influence of the parental-carer dynamic, concerns around patient age and development as a barrier to disclosure) which require further research. We found evidence of the interrelatedness of HCP knowledge, attitudes and behaviours and the ability of these elements to positively influence each other. We mapped our themes across these elements to form a new suggested framework for improving HCP-patient interactions in LGBTQ+ Cancer Care. We found a need both for individual HCP education and organisational change, with creation of a culture of psychological safety to improve patient care. Conclusion Knowledge, attitudes and behaviours of HCPs are closely interdependent when providing care to young LGBTQ+ patients with cancer. The authors suggest that future efforts to improve care of these patients address this complexity by spanning the domains of our suggested framework. Whilst HCP education is essential, change must also occur at an organisational level.
Collapse
Affiliation(s)
- Tamsin Gannon
- Paediatric and Teenage and Young Adult Oncology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom,*Correspondence: Tamsin Gannon,
| | - Bob Phillips
- Paediatric and Teenage and Young Adult (TYA) Oncology, Leeds Children’s Hospital, Leeds, United Kingdom
| | - Daniel Saunders
- Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Alison May Berner
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom,Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
23
|
Ussher JM, Power R, Perz J, Hawkey AJ, Allison K. LGBTQI Inclusive Cancer Care: A Discourse Analytic Study of Health Care Professional, Patient and Carer Perspectives. Front Oncol 2022; 12:832657. [PMID: 35619900 PMCID: PMC9127408 DOI: 10.3389/fonc.2022.832657] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Background Awareness of the specific needs of LGBTQI cancer patients has led to calls for inclusivity, cultural competence, cultural safety and cultural humility in cancer care. Examination of oncology healthcare professionals’ (HCP) perspectives is central to identifying barriers and facilitators to inclusive LGBTQI cancer care. Study Aim This study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers. Method 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%) and leadership (11%) positions took part in a survey; 48 HCPs completed an interview. 430 LGBTQI patients, representing a range of tumor types, sexual and gender identities, age and intersex status, and 132 carers completed a survey, and 104 LGBTQI patients and 31 carers undertook an interview. Data were analysed using thematic discourse analysis. Results Three HCP subject positions – ways of thinking and behaving in relation to the self and LGBTQI patients – were identified:’Inclusive and reflective’ practitioners characterized LGBTQI patients as potentially vulnerable and offered inclusive care, drawing on an affirmative construction of LGBTQI health. This resulted in LGBTQI patients and their carers feeling safe and respected, willing to disclose sexual orientation and gender identity (SOGI) status, and satisfied with cancer care. ‘Egalitarian practitioners’ drew on discourses of ethical responsibility, positioning themselves as treating all patients the same, not seeing the relevance of SOGI information. This was associated with absence of LGBTQI-specific information, patient and carer anxiety about disclosure of SOGI, feelings of invisibility, and dissatisfaction with healthcare. ‘Anti-inclusive’ practitioners’ expressed open hostility and prejudice towards LGBTQI patients, reflecting a cultural discourse of homophobia and transphobia. This was associated with patient and carer distress, feelings of negative judgement, and exclusion of same-gender partners. Conclusion Derogatory views and descriptions of LGBTQI patients, and cis-normative practices need to be challenged, to ensure that HCPs offer inclusive and affirmative care. Building HCP’s communicative competence to work with LGBTQI patients needs to become an essential part of basic training and ongoing professional development. Visible indicators of LGBTQI inclusivity are essential, alongside targeted resources and information for LGBTQI people.
Collapse
Affiliation(s)
- Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Alexandra J Hawkey
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|
24
|
Wakefield D, Kane CE, Chidiac C, Braybrook D, Harding R. Why does palliative care need to consider access and care for LGBTQ people? Palliat Med 2021; 35:1730-1732. [PMID: 34696649 DOI: 10.1177/02692163211055011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Donna Wakefield
- North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-On-Tees, UK
| | | | - Claude Chidiac
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - Debbie Braybrook
- Cicely Saunders Institute of Palliative Care and Rehabilitation, Kings College London, London, UK
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care and Rehabilitation, Kings College London, London, UK
| |
Collapse
|
25
|
Narayan AK, Chowdhry DN, Fintelmann FJ, Little BP, Shepard JAO, Flores EJ. Racial and Ethnic Disparities in Lung Cancer Screening Eligibility. Radiology 2021; 301:712-720. [PMID: 34546133 DOI: 10.1148/radiol.2021204691] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background To address disparities in lung cancer screening (LCS) that may exclude large numbers of high-risk African American smokers, revised U.S. Preventive Services Task Force (USPSTF) recommendations lowered LCS eligibility thresholds. However, there are limited recent data about the impact of newly revised guidelines on disparities in LCS eligibility. Purpose To evaluate the impact of revised USPSTF guidelines on racial and ethnic disparities in LCS eligibility. Materials and Methods Cross-sectional survey data from 20 states were retrospectively evaluated from the 2019 Behavioral Risk Factor Surveillance System survey (median response rate, 49.4%). Respondents without a history of lung cancer aged 55-79 years (ie, under the previous guidelines) or aged 50-79 years (ie, under the revised guidelines) were included. Multivariable logistic regression analyses were performed to evaluate the association between race and ethnicity and LCS eligibility. All analyses were performed accounting for complex survey design features (ie, weighting, stratification, and clustering). Results Under previous guidelines, 11% of 67 567 weighted survey respondents were eligible for LCS (White [12%], Hispanic [4%], African American [7%], American Indian [17%], Asian or Pacific Islander [4%], and other [12%]). Under revised USPSTF guidelines, 14% of 77 689 weighted survey respondents were eligible for LCS (White [15%], Hispanic [5%], African American [9%], American Indian [21%), Asian or Pacific Islander [5%], and other [18%]). Compared with White respondents, African American respondents (adjusted odds ratio [OR] = 0.36; 95% CI: 0.27, 0.47; P < .001) and Hispanic respondents (adjusted OR = 0.15; 95% CI: 0.09, 0.24; P < .001) were less likely to be eligible for LCS under previous guidelines. African American respondents (adjusted OR = 0.39; 95% CI: 0.32, 0.47; P < .001) and Hispanic respondents (adjusted OR = 0.15; 95% CI: 0.10, 0.23; P < .001) were less likely to be eligible under the revised guidelines. The Wald test showed no evidence of differences in the degree to which racial and ethnic minority groups were less likely to be eligible for LCS when comparing previous versus revised USPSTF guidelines (P = .76). Conclusion The revised U.S. Preventive Services Task Force guidelines (version 2.0) may perpetuate lung cancer disparities, as racial and ethnic minority groups are still less likely to be eligible for lung cancer screening. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Jacobs and Springfield in this issue.
Collapse
Affiliation(s)
- Anand K Narayan
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| | - Divya N Chowdhry
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| | - Florian J Fintelmann
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| | - Brent P Little
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| | - Jo-Anne O Shepard
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| | - Efrén J Flores
- From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Wang 219H, Boston, MA 02114
| |
Collapse
|
26
|
Abstract
PURPOSE OF REVIEW A review of the recent literature (2019-2021) around the current disparities in care for LGBT individuals with cancer. RECENT FINDINGS Recent studies highlight that there continue to be multiple barriers to LGBT individuals with cancer receiving equity of care. These include healthcare professionals (HCPs) lack of knowledge of LGBT-specific issues and an under appreciation of the importance of sexuality and gender in order to provide holistic, person-centred care. Suggestions are made of how embedding training, updating guidelines, and improving communication skills could help to address this care disparity. SUMMARY Lesbian, gay, bisexual and/or trans (LGBT) individuals have an increased risk of certain illnesses, including certain types of cancer. They belong to a minority group, who may be subjected to discrimination and so are less likely to present for screening or engage with healthcare professionals. This review of recent studies highlights that LGBT individuals still fear discrimination from HCPs, and that many HCPs themselves admit to poor knowledge of LGBT specific issues and the importance of sexuality and gender identity when providing cancer care. Advances in education programmes, including enhanced communication skills and creating LGBT safe spaces are all vital in reducing the disparity in LGBT cancer care.
Collapse
Affiliation(s)
- Donna Wakefield
- North Tees & Hartlepool NHS Foundation Trust, University Hospital of North Tees, Stockton-on-Tees, UK
| |
Collapse
|
27
|
Conley CC, Otto AK, McDonnell GA, Tercyak KP. Multiple approaches to enhancing cancer communication in the next decade: translating research into practice and policy. Transl Behav Med 2021; 11:2018-2032. [PMID: 34347872 DOI: 10.1093/tbm/ibab089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Communicating risk and other health information in a clear, understandable, and actionable manner is critical for the prevention and control of cancer, as well as the care of affected individuals and their family members. However, the swift pace of development in communication technologies has dramatically changed the health communication landscape. This digital era presents new opportunities and challenges for cancer communication research and its impact on practice and policy. In this article, we examine the science of health communication focused on cancer and highlight important areas of research for the coming decade. Specifically, we discuss three domains in which cancer communication may occur: (a) among patients and their healthcare providers; (b) within and among families and social networks; and (c) across communities, populations, and the public more broadly. We underscore findings from the prior decade of cancer communication research, provide illustrative examples of future directions for cancer communication science, and conclude with considerations for diverse populations. Health informatics studies will be necessary to fully understand the growing and complex communication settings related to cancer: such works have the potential to change the face of information exchanges about cancer and elevate our collective discourse about this area as newer clinical and public health priorities emerge. Researchers from a wide array of specialties are interested in examining and improving cancer communication. These interdisciplinary perspectives can rapidly advance and help translate findings of cancer communication in the field of behavioral medicine.
Collapse
Affiliation(s)
- Claire C Conley
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Amy K Otto
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Glynnis A McDonnell
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Kenneth P Tercyak
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|