Improving the care management of trans patients: Focus groups of nursing students' perceptions

LGBTQIA+ healthcare content in pre-registration nursing and midwifery curricula: A cross-sectional study

BACKGROUND

Nurses and midwives are expected to provide inclusive care for LGBTQIA+ populations. However, there is a paucity of knowledge on how well-prepared nursing and midwifery graduates are for this aspect of their role.

AIM

To explore LGBTQIA+ content in pre-registration nursing and midwifery curricula in Australia.

DESIGN

Cross-sectional study.

SETTINGS

Australian higher education institutions offering 86 pre-registration nursing and midwifery programs.

SAMPLE

Publicly available pre-registration nursing and midwifery course programs in Australia as presented in the online course handbooks of 25 randomly selected educational institutions.

METHODS

A LGBTQIA+ terminology matrix was developed to guide data extraction from subject titles, synopses, and learning outcomes. Explicit terms were those strongly associated with LGBTQIA+. Implicit terms were those indirectly associated with LGBTQIA+. Explicit and implicit LGBTQIA+ terms were analyzed for frequencies. Poisson regression was used to compare counts of LGBTQIA+ terms by course, subject, and university.

RESULTS

Among the 1093 subjects, no subject titles included explicit terms and 6 (0.55 %) titles included implicit LGBTQIA+ terminology. Explicit LGBTQIA+ terminology was identified in 54 (4.9 %) subject synopses and implicit terminology was found in 323 (29.6 %) subject synopses. Explicit LGBTQIA+ terms were identified in 14 (1.3 %) learning outcomes while implicit terms were found in 323 (29.6 %) learning outcomes. Group of Eight universities were more likely to use explicit and implicit LGBTQIA+ terminology than non-Group of Eight universities (p < 0.001; p = 0.035). Undergraduate programs included more LGBTQIA+ terminology than postgraduate programs (p = 0.019; p < 0.001). Core subjects were more likely to include LGBTQIA+ content than elective subjects (p < 0.001).

CONCLUSION

Explicit LGBTQIA+ terminology was minimal indicating limited overall content. The study results alert nursing and midwifery educators to take a targeted approach to teaching and learning with a LGBTQIA+ focus to support future nurses and midwives with quality knowledge and skills and ensure equitable and safe care for LGBTQIA+ people.

Methods of Teaching Transgender Health in Undergraduate Nursing Programs: A Narrative Review

BACKGROUND

Transgender populations experience disproportionately higher rates of mental and physical health issues such as suicidality and heart disease than their cisgender counterparts. Education of health professions students and providers is recognized as an effective method in mitigating transgender health disparities.

PURPOSE

This narrative review investigated the methods in which transgender health is taught in undergraduate nursing programs. Suggestions for optimizing transgender health education are presented.

METHOD

This review critically appraised and synthesized 28 articles that met these inclusion criteria: articles in English describing teaching strategies used in transgender health education with samples that include undergraduate nursing students.

RESULTS

Didactic lecture is the most widely used method, followed by role-play simulation, use of film and video, guest presentation, and high-fidelity and standardized patient simulation.

CONCLUSION

Lectures remain the dominant method of delivering transgender health content. Improvements in students' knowledge and attitude related to transgender care were noted posteducation.

Delivering transgender-specific knowledge and skills into health and allied health studies and training: a systematic review

Many transgender individuals face inequities, discrimination, and sometimes even a lack of transgender-specific knowledge in health care settings. Educational curricula can address such disparities and help future health professionals to become more knowledgeable, confident, and well-prepared for addressing the needs of transgender individuals. This systematic review aims to summarize current training interventions about care of transgender individuals for health and allied health students, and to analyse the effects of the respective intervention. A total of six databases (Pubmed, MEDLINE, Scopus, Web of Science, Embase and SciSearch) were screened for original articles published between 2017 and June 2021. Search terms and eligibility criteria were pre-specified, and after a structured selection process 21 studies were included into further analysis. Extracted data contained information on general study properties, population, design, program format and outcomes of interest. A narrative synthesis was used to summarize detected results. Study quality was assessed for each individual study. A self-developed 18-item checklist combining criteria of two prior published tools was used to assess overall quality of quantitative studies. For qualitative studies a 10-item checklist by Kmet et al. [HTA Initiat, 2004] was applied. Eligible studies were designed for multiple health or allied health profession students, and varied widely regarding program format, duration, content, and assessed outcomes. Almost all (N = 19) interventions indicated improvements in knowledge, attitude, confidence and comfort levels or practical skills concerning care for transgender clients. Major limitations included the lack of long-term data, validated assessment tools, control groups and comparative studies. Training interventions contribute to prepare future health professionals to deliver competent and sensitive care and which may improve the prospective experienced health care reality of transgender individuals. However, currently there is no common consensus about best practice of education. Additionally, little is known about whether detected effects of training interventions translate into noticeable improvements for transgender clients. Further studies are warranted to assess the direct impact of specific interventions in the light of the respective target populations.

Primary Healthcare Nurse’s Barriers and Facilitators to Providing Sexual and Reproductive Healthcare Services of LGBTQI Individuals: A Qualitative Study

In most cases, we only hear Lesbians, Gays, Bisexuals, Transgender, Queer, and Intersex (LGBTQI) patients complaining about nurses being the reason for not accessing and utilizing healthcare services; for example, studies reports on the different attitudes of healthcare providers including nurses against LGBTQI patients. However, factors influencing the behavior of South African Primary Healthcare (PHC) Nurses toward LGBTQI patients are rarely reported. The study aimed to explore how PHC nurses experienced and perceived sexual and reproductive health services for LGBTQI individuals in Tshwane, Gauteng Province, South Africa. The study followed qualitative research using an exploratory design approach. The sample included 27 PHC nurses from Tshwane, Gauteng Province, South Africa. In-depth face-to-face interviews were coded and analyzed using Thematic Content Analysis (TCA) which included five interrelated steps. The results revealed three main themes: barriers to the provision of LGBTQI-related SRHS, facilitators for the provision of SRHS to LGBTQI individuals, and strategies to improve LGBTQI individuals’ SRHS accessibility and availability. Common barriers were related to the institutions, PHC nurses, the general public, and LGBTQI patients themselves. Regardless of the challenges faced by PHC nurses, there were some enabling factors that pushed them to continue rendering SHRS to LGBTQI patients who came to their clinics. Almost all PHC nurses suggested the importance of awareness, transparency, collaboration, and the need for training related to LGBTQI healthcare issues.

Transgender people in the nursing discourse: An integrative review

OBJECTIVE

To integrate and analyse the literature produced by nurses in terms of care, education and understanding of the reality of transgender (trans) people.

DESIGN

An integrative review methodology guided by the framework proposed by Whittemore and Knafl.

DATA SOURCES

The search strategy was applied in the following databases: Medline, Embase, Scopus, Web of Science and CINAHL, as well as in Biblioteca Virtual de Saúde, during February and March 2021, with no time frame.

REVIEW METHODS

The references found were assessed according to the eligibility criteria established. The information of the articles included was extracted, and a thematic analysis was performed to synthesize the review findings.

RESULTS

The searches in the databases yielded 2859 articles; 985 after removing duplicates, and 33 articles were included in this review. Three major themes were identified: (1) Understanding the trans universe through the trans perspective; (2) Understanding health and nursing care for trans people; and (3) Trans women as the focus of health and nursing care. The themes evidenced in the lens of nurses and clients the importance of nursing training at all levels to prepare professionals on how to provide culturally competent nursing care for this population and reduce healthcare inequities.

CONCLUSION

Nurses must work to provide a space for convergence and enhancement of the rights of trans people and cease to be a verticalized care model. To such end, it is necessary to devise places and possibilities to teach and learn, to construct and reconstruct a culturally competent nursing care.

IMPACT

This review highlighted the current knowledge and identified gaps in the understanding of nurses, health professionals and students about the experience lived by trans people, resulting from the lack of training and continuing education of these professionals.

Attitudes of nursing students towards LGBT individuals and the affecting factors

PURPOSE

To determine the attitudes of nursing students towards LGBT (lesbian, gay, bisexual, and transgender) individuals and the affecting factors.

DESIGN AND METHOD

The universe of the research consisted of 500 students. The data collection tools used were "Demographic Data Form" and "Attitude towards Lesbians and Gay Men Scale (ATLG)."

FINDINGS

Students' attitudes towards LGBT individuals are at a medium level. Male participants had more negative attitudes towards LGBT individuals.

PRACTICAL IMPLICATIONS

Nurses should provide services within the framework of professional values. In this context, vulnerable groups should be handled carefully. Awareness should be created among nurses.