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Anderson MR, Burtch G, Greenwood BN. The impact of abortion restrictions on American mental health. SCIENCE ADVANCES 2024; 10:eadl5743. [PMID: 38959323 PMCID: PMC11221505 DOI: 10.1126/sciadv.adl5743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/23/2024] [Indexed: 07/05/2024]
Abstract
The overturning of Roe v. Wade has led to numerous states enacting new abortion restrictions. However, limited empirical evidence exists regarding the general mental health impact of these bans. Leveraging the nationwide Household Pulse Survey, we evaluate the impact of emergent gestational limits and outright bans on self-reported mental health status between July 2021 and June 2023 using a difference in difference approach. Responses indicate a significant increase in reports of mental distress after the institution of such restrictions. These effects appear to persist at least 4 months following a ban and are moderated by household income and education but not by sex, race, age, marital status, or sexual orientation. Less educated and less wealthy subjects reported greater mental health distress compared to wealthier, more educated groups. These results suggest that the institution of abortion restrictions has had broad negative implications for the mental health of people living in the US, particularly those of lower education and personal wealth.
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Affiliation(s)
| | - Gordon Burtch
- Questrom School of Business, Boston University, Boston, MA, USA
| | - Brad N. Greenwood
- George Mason School of Business, George Mason University, Fairfax, VA, USA
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2
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Nicol AAM, Tóth-Király I. Relations Between Rape Myths, Ambivalent Sexism, Social Dominance Orientation, and Right-Wing Authoritarianism Across Gay and Straight Women and Men: More Similar Than Dissimilar. JOURNAL OF SEX RESEARCH 2024:1-16. [PMID: 38959089 DOI: 10.1080/00224499.2024.2371951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Rape myths support and fuel cultural understandings regarding gender roles and deny the victim's rights and strengthen those of the instigator. Little research exists examining the invariance of rape myths measures and models used to explain rape myths across gay and straight samples. Examining correlates of rape myths and determining if the pattern of relations between correlates is similar across gay and straight male and female samples provides insights into socially constant factors that are influencing rape myth acceptance. Participants (294 straight women, 282 gay women, 293 straight men, and 234 gay men) were asked to complete measures of social dominance orientation (SDO), right-wing authoritarianism (RWA), ambivalent sexism toward women, ambivalent sexism toward men, and rape myths toward women. We tested four models that highlighted significant, direct paths between SDO, RWA, and rape myth acceptance. Both hostile sexism toward women and benevolent sexism toward men demonstrated significant indirect effects between SDO, RWA, and rape myth acceptance. Benevolent sexism toward women and hostile sexism toward men demonstrated, in most samples, significant indirect effects between SDO, RWA, and rape myth acceptance. However, the strength of those relations differed for gay and heterosexual samples. This provides further understanding of rape myths as SDO, RWA, and benevolent and hostile sexism toward men and women play a role in supporting rape myth acceptance and establishes that, overall, these relations are more similar than dissimilar across straight and gay samples.
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Affiliation(s)
- Adelheid A M Nicol
- Military Psychology and Leadership Department, The Royal Military College of Canada
| | - István Tóth-Király
- Substantive-Methodological Synergy Research Laboratory, Concordia University
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O’Shea J, James R, Nicholls D, Downs J, Hudson LD. Prevalence, severity and risk factors of psychiatric disorders amongst sexual and gender diverse young people during the COVID-19 pandemic: A systematic review. Clin Child Psychol Psychiatry 2024; 29:1213-1227. [PMID: 38290723 PMCID: PMC11188558 DOI: 10.1177/13591045241229751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic's fallout.
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Affiliation(s)
- Jonathan O’Shea
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Rachel James
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, UK
| | - James Downs
- Faculty of Eating Disorders, Royal College of Psychiatrists, UK
| | - Lee D Hudson
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
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Hempeler C, Schneider-Reuter L, Windel AS, Carlet J, Philipsen L, Juckel G, Gather J, Yeboah A, Faissner M. Intersectional Discrimination in Mental Health Care: A Systematic Review With Qualitative Evidence Synthesis. Psychiatr Serv 2024:appips20230252. [PMID: 38938095 DOI: 10.1176/appi.ps.20230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Discriminatory practices in mental health care undermine the right to health of marginalized service users. Intersectional approaches enable consideration of multiple forms of discrimination that occur simultaneously and remain invisible in single-axis analyses. The authors reviewed intersectionality-informed qualitative literature on discriminatory practices in mental health care to better understand the experiences of marginalized service users and their evaluation and navigation of mental health care. METHODS The authors searched EBSCO, PubMed, MEDLINE, and JSTOR for studies published January 1, 1989-December 14, 2022. Qualitative and mixed-methods studies were eligible if they used an intersectional approach to examine discrimination (experiences, mechanisms, and coping strategies) in mental health care settings from the perspective of service users and providers. A qualitative evidence synthesis with thematic analysis was performed. RESULTS Fifteen studies were included in the qualitative evidence synthesis. These studies represented the experiences of 383 service users and 114 providers. Most studies considered the intersections of mental illness with race, sexual and gender diversity, or both and were performed in the United States or Canada. Four themes were identified: the relevance of social identity in mental health care settings, knowledge-related concerns in mental health care, microaggressions in clinical practice, and service users' responses to discriminatory practices. CONCLUSIONS Discriminatory practices in mental health care lead to specific barriers to care for multiply marginalized service users. Universities and hospitals may improve care by building competencies in recognizing and preventing discrimination through institutionalized training.
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Affiliation(s)
- Christin Hempeler
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lydia Schneider-Reuter
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Anne-Sophie Windel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jona Carlet
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Lea Philipsen
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Georg Juckel
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Jakov Gather
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Amma Yeboah
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
| | - Mirjam Faissner
- Institute for Medical Ethics and History of Medicine (Hempeler, Schneider-Reuter, Carlet, Philipsen, Gather) and Department of Psychiatry, Psychotherapy and Preventive Medicine (Juckel, Gather, Faissner), Ruhr University Bochum, Bochum, Germany; private practice for general medicine, Cologne, Germany (Windel); Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich (Carlet); private practice for psychiatry and psychotherapy, and psychodynamic supervision, Cologne, Germany (Yeboah); Institute of the History of Medicine and Ethics in Medicine, Charité-Universitätsmedizin Berlin, Berlin (Faissner)
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Hillier B, Carthy E, Kalk N, Moncrieff M, Pakianathan M, Tracy D, Bowden-Jones O, Hickson F, Forrester A. Developing a coordinated response to chemsex across health, justice and social care settings: expert consensus statement. BJPsych Bull 2024:1-8. [PMID: 38916191 DOI: 10.1192/bjb.2024.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
SUMMARY Chemsex occurs primarily among gay, bisexual and other men who have sex with men (GBMSM), and there is evidence of a subgroup of users who carry out chemsex-related criminal offences and experience harm. Challenges with chemsex can present to various settings; there are concerns that harm is increasing, including at interfaces between health, social care and criminal justice systems. The UK response to date has lacked a coordinated approach. An expert reference group was convened to share chemsex knowledge, articulate priorities for research and pathway development, and foster collaborative working between agencies. It made three key recommendations: develop and increase training and awareness across all services; implement a coordinated research programme with the development of a common data-set and assessment tool to fully characterise population-level needs; develop a professional network to share information, provide professional support and act as a knowledge hub. There was support for a unified multi-agency strategy incorporating the priorities identified as overarching principles.
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Affiliation(s)
- Bradley Hillier
- West London NHS Trust, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Eliott Carthy
- West London NHS Trust, London, UK
- University of Oxford, Oxford, UK
| | - Nicola Kalk
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | | | | | | | - Ford Hickson
- London School of Hygiene and Tropical Medicine, London, UK
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Gonçalves CC, Waters Z, Quirk SE, Haddad PM, Lin A, Williams LJ, Yung AR. Barriers and facilitators to mental health treatment access and engagement for LGBTQA+ people with psychosis: a scoping review protocol. Syst Rev 2024; 13:143. [PMID: 38816775 PMCID: PMC11137929 DOI: 10.1186/s13643-024-02566-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The prevalence of psychosis has been shown to be disproportionately high amongst sexual and gender minority individuals. However, there is currently little consideration of the unique needs of this population in mental health treatment, with LGBTQA+ individuals facing barriers in accessing timely and non-stigmatising support for psychotic experiences. This issue deserves attention as delays to help-seeking and poor engagement with treatment predict worsened clinical and functional outcomes for people with psychosis. The present protocol describes the methodology for a scoping review which will aim to identify barriers and facilitators faced by LGBTQA+ individuals across the psychosis spectrum in help-seeking and accessing mental health support. METHODS A comprehensive search strategy will be used to search Medline, PsycINFO, Embase, Scopus, LGBTQ+ Source, and grey literature. Original studies of any design, setting, and publication date will be included if they discuss barriers and facilitators to mental health treatment access and engagement for LGBTQA+ people with experiences of psychosis. Two reviewers will independently screen titles/abstracts and full-text articles for inclusion in the review. Both reviewers will then extract the relevant data according to pre-determined criteria, and study quality will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Key data from included studies will be synthesised in narrative form according to the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. DISCUSSION The results of this review will provide a comprehensive account of the current and historical barriers and facilitators to mental healthcare faced by LGBTQA+ people with psychotic symptoms and experiences. It is anticipated that the findings from this review will be relevant to clinical and community services and inform future research. Findings will be disseminated through publication in a peer-reviewed journal and presented at conferences. SCOPING REVIEW REGISTRATION This protocol is registered in Open Science Framework Registries ( https://doi.org/10.17605/OSF.IO/AT6FC ).
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Affiliation(s)
- Cláudia C Gonçalves
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia.
| | - Zoe Waters
- Telethon Kids Institute, University of Western Australia, Perth, WA, 6009, Australia
| | - Shae E Quirk
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia
| | - Peter M Haddad
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, 3220, Australia
| | - Ashleigh Lin
- School of Population and Global Health, University of Western Australia, Perth, WA, 6009, Australia
| | - Lana J Williams
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia
| | - Alison R Yung
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
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Ho SH, Shamsudin AH, Liow JW, Juhari JA, Ling SA, Tan K. Mental Healthcare Needs and Experiences of LGBT+ Individuals in Malaysia: Utility, Enablers, and Barriers. Healthcare (Basel) 2024; 12:998. [PMID: 38786409 PMCID: PMC11120647 DOI: 10.3390/healthcare12100998] [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: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey (n = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments (n = 273), with relevance drawn to Andersen's Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners' stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.
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Affiliation(s)
- Sheau Huey Ho
- Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia;
| | - Amirul Hakim Shamsudin
- Department of English, Faculty of Languages and Linguistics, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Jun Wei Liow
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam 999077, Hong Kong;
| | | | - Sai Ang Ling
- Faculty of Social Science and Humanities, Tunku Abdul Rahman University of Management and Technology, Setapak, Kuala Lumpur 53300, Malaysia;
| | - Kyle Tan
- Faculty of Māori and Indigenous Studies, University of Waikato, Hamilton 3240, New Zealand;
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Bursztein Lipsicas C, Hamdan S, Gal G. Emotional Distress, Suicidal Behavior, and Help-Seeking Among Transgender and Gender Diverse People in Israel. Transgend Health 2024; 9:174-179. [PMID: 38585245 PMCID: PMC10998021 DOI: 10.1089/trgh.2022.0058] [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: 01/10/2023] Open
Abstract
Purpose The aim of this study was to evaluate emotional distress, suicidality, and help-seeking among Israeli transgender and gender diverse (TGD) persons. Methods TGD (n=139) and cisgender (n=275) participants reported on suicidal thoughts and behavior (STB), help-seeking behavior, and emotional distress (General Health Questionnaire [GHQ-12]) in an online survey. Results GHQ-12 and STB were significantly higher among TGD compared with cisgender participants. More TGD participants reported seeking help. Conclusion TGD persons reported high levels of emotional distress and STB, suggesting that their needs for mental health care are not met by the Israeli health services.
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Affiliation(s)
| | - Sami Hamdan
- School of Psychology, The Academic College of Tel Aviv Yaffo, Tel Aviv, Israel
| | - Gilad Gal
- School of Psychology, The Academic College of Tel Aviv Yaffo, Tel Aviv, Israel
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Gasteiger C, Collens P, du Preez E. Community-based support to improve mental health and wellbeing in older sexually and gender diverse people: a scoping review. Aging Ment Health 2024; 28:692-700. [PMID: 37855436 DOI: 10.1080/13607863.2023.2269097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES This scoping review seeks to identify what community-based support is used by older sexually and gender diverse (SGD) people, that aims to improve mental health/wellbeing. METHODS A scoping review was conducted using the Arksey and O'Malley framework. APA PsycInfo, Embase, MEDLINE, PubMed, and Scopus were searched. Key information was extracted and entered into a structured coding sheet before being summarized. RESULTS Seventeen studies were included (41% observational qualitative and 35% observational quantitative). The most commonly used community-based support was lesbian, gay, bisexual and transgender (LGBT) social groups. A range of practices were reported in five studies, including in SGD affirming religious congregations and mind-body practices. Two studies reported the use of formal programmes, with one based on a group initiative. Positive outcomes included feeling connected, improved social support and mental health, and coping with illness. Five studies reported null or negative findings, including a lack of acceptance. Most studies used categories for sex and gender inaccurately, and lacked detail when describing community-based support. CONCLUSION The use of community-based support by older SGD people is underexplored. More interventions designed for and by this community are needed, along with experimental research to draw conclusions on effectiveness to improve mental health or wellbeing.
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Affiliation(s)
- Chiara Gasteiger
- School of Clinical Sciences, AUT University, Auckland, New Zealand
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Paula Collens
- School of Clinical Sciences, AUT University, Auckland, New Zealand
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Bragazzi NL, Crapanzano A, Converti M, Zerbetto R, Khamisy-Farah R. The Impact of Generative Conversational Artificial Intelligence on the Lesbian, Gay, Bisexual, Transgender, and Queer Community: Scoping Review. J Med Internet Res 2023; 25:e52091. [PMID: 37864350 PMCID: PMC10733821 DOI: 10.2196/52091] [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: 08/22/2023] [Revised: 09/28/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Despite recent significant strides toward acceptance, inclusion, and equality, members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community still face alarming mental health disparities, being almost 3 times more likely to experience depression, anxiety, and suicidal thoughts than their heterosexual counterparts. These unique psychological challenges are due to discrimination, stigmatization, and identity-related struggles and can potentially benefit from generative conversational artificial intelligence (AI). As the latest advancement in AI, conversational agents and chatbots can imitate human conversation and support mental health, fostering diversity and inclusivity, combating stigma, and countering discrimination. In contrast, if not properly designed, they can perpetuate exclusion and inequities. OBJECTIVE This study aims to examine the impact of generative conversational AI on the LGBTQ community. METHODS This study was designed as a scoping review. Four electronic scholarly databases (Scopus, Embase, Web of Science, and MEDLINE via PubMed) and gray literature (Google Scholar) were consulted from inception without any language restrictions. Original studies focusing on the LGBTQ community or counselors working with this community exposed to chatbots and AI-enhanced internet-based platforms and exploring the feasibility, acceptance, or effectiveness of AI-enhanced tools were deemed eligible. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). RESULTS Seven applications (HIVST-Chatbot, TelePrEP Navigator, Amanda Selfie, Crisis Contact Simulator, REALbot, Tough Talks, and Queer AI) were included and reviewed. The chatbots and internet-based assistants identified served various purposes: (1) to identify LGBTQ individuals at risk of suicide or contracting HIV or other sexually transmitted infections, (2) to provide resources to LGBTQ youth from underserved areas, (3) facilitate HIV status disclosure to sex partners, and (4) develop training role-play personas encompassing the diverse experiences and intersecting identities of LGBTQ youth to educate counselors. The use of generative conversational AI for the LGBTQ community is still in its early stages. Initial studies have found that deploying chatbots is feasible and well received, with high ratings for usability and user satisfaction. However, there is room for improvement in terms of the content provided and making conversations more engaging and interactive. Many of these studies used small sample sizes and short-term interventions measuring limited outcomes. CONCLUSIONS Generative conversational AI holds promise, but further development and formal evaluation are needed, including studies with larger samples, longer interventions, and randomized trials to compare different content, delivery methods, and dissemination platforms. In addition, a focus on engagement with behavioral objectives is essential to advance this field. The findings have broad practical implications, highlighting that AI's impact spans various aspects of people's lives. Assessing AI's impact on diverse communities and adopting diversity-aware and intersectional approaches can help shape AI's positive impact on society as a whole.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, CA, United States
| | - Manlio Converti
- Department of Mental Health, Local Health Unit ASL Napoli 2 Nord, Naples, Italy
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11
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Diaz JE, Preciado E, Chiasson MA, Hirshfield S. Association Between Age of Anal Sex Debut and Adult Health Behaviors Among Sexual Minoritized Men Living with HIV. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3565-3575. [PMID: 37378702 PMCID: PMC11034742 DOI: 10.1007/s10508-023-02642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Earlier age of anal sex debut (ASD) has been linked with contemporary and long-term health outcomes, including vulnerability to HIV acquisition. The goal of this study was to utilize a life course approach to examine associations between earlier ASD and recent health behaviors among sexual minoritized men (SMM) living with HIV. A total of 1156 U.S. SMM living with HIV recruited from social and sexual networking apps and websites completed online surveys as part of a longitudinal eHealth intervention. Data from baseline surveys were analyzed to determine associations between age of ASD and adult health outcomes, including mental health, HIV viral load, and substance use. The median age of ASD among these participants was 17 years old, consistent with other work. Earlier ASD was significantly associated with a greater likelihood of past 2-week anxiety (AOR = 1.45, 95% CI 1.07-1.97) and past 3-month opioid use (AOR = 1.60, 95% CI 1.13-2.26); no significant associations were found for recent depression, HIV viral load, or stimulant use. Earlier ASD may function as an important proxy measure for deleterious health outcomes in adulthood, particularly recent anxiety and opioid use. Expansion of comprehensive and affirming sexual health education is critical to early engagement of individuals with a higher risk of HIV acquisition, with plausible downstream health benefits lasting into adulthood among SMM living with HIV.
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Affiliation(s)
- José E Diaz
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | | | - Mary Ann Chiasson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
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Cunningham R, Imlach F, Haitana T, Every-Palmer S, Lacey C, Lockett H, Peterson D. It's not in my head: a qualitative analysis of experiences of discrimination in people with mental health and substance use conditions seeking physical healthcare. Front Psychiatry 2023; 14:1285431. [PMID: 37908598 PMCID: PMC10613695 DOI: 10.3389/fpsyt.2023.1285431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction Clinician bias contributes to lower quality healthcare and poorer health outcomes in people with mental health and substance use conditions (MHSUC). Discrimination can lead to physical conditions being overlooked (diagnostic overshadowing) or substandard treatment being offered to people with MHSUC. This research aimed to utilise experiences of people with MHSUC to identify discrimination by clinicians, including the role of clinician's beliefs and assumptions in physical health service provision. Methods We surveyed people with MHSUC who accessed physical healthcare services. Of 354 eligible participants, 253 responded to open-ended questions about experiences of those services. Thematic descriptive analysis of survey responses was completed using existing stigma frameworks and inductive coding. Results One dominant theme from survey responses was that diagnostic overshadowing by clinicians was driven by clinician mistrust. Another theme was that clinicians assumed respondent's physical symptoms, including pain, were caused by MHSUC. This influenced decisions not to initiate investigations or treatment. Respondents perceived that clinicians focused on mental health over physical health, contributing to suboptimal care. Discussion Discrimination based on MHSUC leads to poor quality care. Health systems and clinicians need to focus quality improvement processes on access to and delivery of equitable physical healthcare to people with MHSUC, address stereotypes about people with MHSUC and improve integration of mental and physical healthcare.
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Affiliation(s)
- Ruth Cunningham
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Fiona Imlach
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Tracy Haitana
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Cameron Lacey
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Helen Lockett
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Debbie Peterson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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13
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Uffman JC, Willer BL, Mpody C, Nafiu OO, Tobias JD. Characteristics of Transgender and Gender-Diverse Youth Presenting for Surgery in the United States. Anesth Analg 2023; 137:882-886. [PMID: 37471293 DOI: 10.1213/ane.0000000000006618] [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: 07/22/2023]
Abstract
BACKGROUND The number of adolescents and adults identifying as trans or gender-diverse is increasing. The lesbian, gay, bisexual, transgender, queer, and "other" (LGBTQ+) population is recognized as a marginalized health care population. This retrospective study sought to investigate demographic trends in transgender and gender-diverse (TGD) youth accessing surgical care in the United States. METHODS Using a multi-institutional dataset from the Pediatric Health Information System (PHIS), we described demographic and periprocedural data for TGD adolescents, ages 10 to 18 years, who underwent a surgical procedure between January 1, 2016 and August 31, 2022. RESULTS Among 767,224 youth who underwent surgical procedures during the study period, 807 (0.1%, 95% confidence interval [CI], 0.09-0.11) were identified as TGD. The overall prevalence of identified TGD youth increased from 0.02% in 2016 to 0.23% in 2022. TGD youth were mostly (71%) assigned female at birth and 13 to 18 years of age (91%, 733/807) at the time of surgery. A total of 76% of TGD patients were non-Hispanic White, 62% had commercial insurance, and 49% lived in a ZIP code with a median annual income between $39,000 and $63,000. Of the 807 TGD patients identified, 264 (33%) were from the Northeast, 226 (28%) were from the Midwest, 219 (27%) were from the West, and 98 (12%) were from the South census regions. The most common procedures for TGD youth to undergo were breast reduction/augmentation (n = 135), insertion/removal of subcutaneous implant device (n = 98), and orthopedic procedures of the hip and lower extremity (n = 29). CONCLUSIONS We reported the perioperative characteristics of TGD youth and showed a steady increase in the detected prevalence of TGD adolescents accessing surgical care. Future investigations into specific challenges associated with caring for these patients are warranted.
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Affiliation(s)
- Joshua C Uffman
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and the Department of Anesthesiology & Pain Medicine, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Brittany L Willer
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and the Department of Anesthesiology & Pain Medicine, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Christian Mpody
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and the Department of Anesthesiology & Pain Medicine, Columbus, Ohio
| | - Olubukola O Nafiu
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and the Department of Anesthesiology & Pain Medicine, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Joseph D Tobias
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and the Department of Anesthesiology & Pain Medicine, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio
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14
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Barreto M. Statutory mental health services in the UK do not meet the needs of people from ethnic minority groups. Evid Based Nurs 2023; 26:157. [PMID: 37258088 DOI: 10.1136/ebnurs-2023-103697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
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15
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Soner G, Aydin Avci İ. LGBTI + Persons' Experiences, Expectations, and Suggestions for Improving LGBTI + Healthcare Services in Turkey: A Qualitative Study. Issues Ment Health Nurs 2023; 44:834-843. [PMID: 37619222 DOI: 10.1080/01612840.2023.2245903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
This study aimed to explore the experiences, expectations, and suggestions of LGBTI + persons from the health system in Turkey and their views on what kind of a health system they wish to have. Qualitative descriptive research was used as one of the qualitative research methods. Thirteen LGBTI + persons living in different provinces of Turkey were interviewed. While selecting the participants, the maximum diversity sampling method, one of the purposive sampling methods, was employed. Attention was paid to interview participants from different groups among LGBTI + persons (three gay men, five trans men, two trans women, one queer person, one lesbian person and one bisexual person). Thematic analysis was performed for the analysis of individual in-depth interviews. The expectations of the participants were grouped under three themes: (a) institutional functioning, (b) legal regulations, and (c) healthcare professionals. Each theme and 9 sub-themes demonstrate what kind of a health system LGBTI + persons want to have. Some of the common expectations of the participants are having LGBTI + friendly and free healthcare services, adoption of anti-discrimination laws, and receiving healthcare from professionals with LGBTI+-specific healthcare knowledge. Changes to be made by policy makers, hospital administrators and healthcare professionals in line with the results obtained from the research can improve the experiences of LGBTI + persons in terms of receiving a higher quality healthcare service.
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Affiliation(s)
- Güven Soner
- Faculty of Health Sciences, Department of Public Health Nursing, Ondokuz Mayis University, Samsun, Turkey
| | - İlknur Aydin Avci
- Faculty of Health Sciences, Department of Public Health Nursing, Ondokuz Mayis University, Samsun, Turkey
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16
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Alkış Küçükaydın M, Sayıcı E. Predictors of Belief in Sexual Myths: An Examination in Terms of Gender, Demographic Characteristics, Religiosity, and Childhood Trauma. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:529-542. [PMID: 38601806 PMCID: PMC10903559 DOI: 10.1080/19317611.2023.2251974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/21/2023] [Indexed: 04/12/2024]
Abstract
Objectives Sexual myths are exaggerated beliefs that have no scientific basis. Buying into these beliefs can lead to any number of sexual dysfunctions and decreased quality of life. Therefore, it is necessary to uncover the factors associated with sexual myths and to provide remedial services for anyone struggling with them. Methods This study was conducted to determine the variables affecting sexual myths. Gender, demographic variables (family type, region of residence, and talking about sexuality with parents), religiosity, and childhood trauma were included as independent variables in the study. A total of 375 teacher candidates participated in the study. Data was collected using a personal information form, Sexual Myths Scale, Religiosity Scale, and Childhood Trauma Questionnaire. Results Descriptive analyses and linear multiple regression analysis were used in the study, and both adherence to sexual myths and experienced childhood trauma were found to be high in the teacher candidates who did not talk about sexuality with their families. Conclusions The results of the analysis showed that gender and religiosity were significant predictors of sexual myths. The findings were discussed in light of the literature.
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Affiliation(s)
| | - Elif Sayıcı
- Eregli Faculty of Education, Necmettin Erbakan University, Konya, Turkey
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17
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Batra K, Pharr JR, Kachen A, Godbey S, Terry E. Investigating the Psychosocial Impact of COVID-19 Among the Sexual and Gender Minority Population: A Systematic Review and Meta-Analysis. LGBT Health 2023; 10:416-428. [PMID: 37022764 DOI: 10.1089/lgbt.2022.0249] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Purpose: The purpose of this study was to utilize a systematic review and meta-analysis to assess the existing body of literature to understand the mental health impacts of the coronavirus disease-19 (COVID-19) pandemic among sexual and gender minority (SGM) people. Methods: The search strategy was developed by an experienced librarian and used five bibliographical databases, specifically PubMed, Embase, APA PsycINFO (EBSCO), Web of Science, and LGBTQ+ Source (EBSCO), for studies (published 2020 to June, 2021) examining the psychological impact of the COVID-19 pandemic among SGM people. Articles were screened by two reviewers. The quality of the articles was assessed using the National Institutes of Health quality assessment tool for observational studies. A double extraction method was used for data abstraction. Heterogeneity among studies was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled prevalence. Publication bias was assessed by Funnel plot and Egger's linear regression test. Results: Of a total of 37 studies, 15 studies were included in the meta-analysis with 17,973 SGM participants. Sixteen studies were U.S. based, seven studies were multinational studies, and the remaining studies were from Portugal, Brazil, Chile, Taiwan, the United Kingdom, France, Italy, Canada, and several other countries. A majority of studies used psychometric valid tools for the cross-sectional surveys. The pooled prevalence of anxiety, depression, psychological distress, and suicidal ideation was 58.6%, 57.6%, 52.7%, and 28.8%, respectively. Conclusions: Findings of this study serve as evidence to develop appropriate interventions to promote psychological wellbeing among vulnerable population subgroups, such as SGM individuals.
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Affiliation(s)
- Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Axenya Kachen
- School of Medicine, University of Reno, Reno, Nevada, USA
| | - Samantha Godbey
- Library Liaison Program, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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18
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Barnett ML, Salem H, Rosas YG, Feinberg E, Nunez-Pepen R, Chu A, Belmont-Ryu H, Matsuno E, Broder-Fingert S. Adapting Community Health Worker Care Models to Advance Mental Health Services Among LGBTQ Youth. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:658-672. [PMID: 37071315 PMCID: PMC10258167 DOI: 10.1007/s10488-023-01268-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/19/2023]
Abstract
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth of color experience high rates of mental health disorders, yet they experience challenges to accessing mental health services. Community health worker (CHW) models of care have potential to promote equitable mental health services among LGBTQ youth. Our aim was to understand how CHW models could be adapted to better support LGBTQ youth of color in accessing mental health services. Semi-structured qualitative interviews were conducted with LGBTQ youth of color (n = 16), caregivers of LGBTQ youth (n = 11), and CHWs (n = 15) in Massachusetts and California. Interviews were coded by 8 members of the research team. A Rapid Qualitative Analysis was conducted to identify themes. Caregivers, youth, and CHWs all endorsed the value of CHW models for this population. They also almost universally suggested multiple adaptations are needed for the model to be effective. Four main categories of themes emerged related to intervention adaptations: (1) Why adaptations are needed for LGBTQ youth, (2) Who should serve as CHWs providing care, (3) How CHWs should be trained, and (4) What content needs to be included in the intervention. Broadly, findings suggest the relevance of having CHW models for LGBTQ youth of color to address stigma and discrimination experienced, access to culturally and linguistically relevant services, and the need for caregiver support of LGBTQ youth. CHWs need increased training in these areas.
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Affiliation(s)
- Miya L Barnett
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA.
| | - Hanan Salem
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Yessica Green Rosas
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Emily Feinberg
- Boston University School of Medicine, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | | | | | - Hana Belmont-Ryu
- Department of Counseling, Clinical, and School Psychology, Gervitz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Em Matsuno
- Arizona State University, Tempe, AZ, USA
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19
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Ellis ÉM, Tate A. Is Trauma Exposure More Harmful for Sexual Minority Youth? Differences in Trauma-Suicide Associations in a Nationally Representative Sample of U.S. Youth and Implications for Suicide Prevention. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:173-182. [PMID: 37234833 PMCID: PMC10205931 DOI: 10.1007/s40653-022-00475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 05/28/2023]
Abstract
Purpose Lesbian, gay, and bisexual (LGB) youth experience disproportionately high rates of suicidality and exposure to traumatic events, such as sexual violence and teen dating violence. Rates of suicidality and exposure to traumatic events also vary by sexual minority subgroup. The purpose of this study was to: (1) explore the impact of LGB identity on the relationship between violence exposure and suicide; and (2) to examine variations by sexual identity. Method A subsample of respondents who reported on their sexual identity in the Youth Risk Behavior Survey (n = 14,690) was used to examine if the associations between sexual and dating violence with suicide outcomes (suicidal ideation, planning, and suicide attempt) depended on the sexual identity of the respondent. Logistic regression models were fitted with an interaction effect to quantify heterogeneity of associations across identity strata. Results Overall interaction tests mostly indicated heterogeneity of associations between sexual violence and physical dating violence. Several contrast of strata associations suggested substantive probability differences between sexual minority respondents and their heterosexual peers. Conclusion While exposure to violence was broadly associated with increased probability of experiencing any type of suicidality, LGB and questioning youth were significantly more likely to experience suicidality compared to their heterosexual peers. Gay and lesbian youth demonstrated the strongest probability of experiencing suicidal thoughts and behaviors among survivors of sexual violence, while bisexual youth may be more at risk following dating violence. Implications for future research and suicide prevention are discussed.
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Affiliation(s)
- Émilie M. Ellis
- College of Public Health, University of Georgia, 101 Buck Rd, 30606 Athens, GA USA
| | - Allan Tate
- College of Public Health, University of Georgia, 101 Buck Rd, 30606 Athens, GA USA
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20
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Cleofas JV, Alibudbud RC. Emerging From a Two-Year-Long Quarantine: A Retrospective Study on Life Satisfaction Trajectory and Depression Among Young LGBTQ+ Students in the Philippines. SAGE Open Nurs 2023; 9:23779608231158980. [PMID: 36861049 PMCID: PMC9969438 DOI: 10.1177/23779608231158980] [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: 01/12/2023] [Accepted: 02/04/2023] [Indexed: 02/26/2023] Open
Abstract
Background Evidence suggests that lesbian, gay, bisexual, trans, queer, and other gender and sexual minorities (LGBTQ+) may experience heightened mental health disparities during the COVID-19 pandemic. Since long periods of confinement and physical restriction due to disease outbreaks can adversely affect mental health, there is a need to explore their effects among LGBTQ+ youth as society recovers from the pandemic. Aims This study determined the longitudinal association between depression and life satisfaction trajectory from the beginning of the COVID-19 pandemic in 2020 to pandemic-induced community quarantine in 2022 among young LGBTQ+ students. Methods This study surveyed 384 conveniently sampled youths (18-24 years old) who identify as LGBTQ+ from locales under two-year-long community quarantine in the Philippines. Respondents' life satisfaction trajectory was measured for 2020, 2021, and 2022. Post-quarantine depression was measured using the Short Warwick Edinburgh Mental Wellbeing Scale. Results One out of four respondents has depression. Those from less than high-income households had a higher risk for depression. Repeated measures analysis of variance revealed that those with more pronounced improvements in life satisfaction throughout and after community quarantine among respondents have a lower risk of depression. Conclusion Life satisfaction trajectory can influence the risk for depression among young LGBTQ+ students during extended periods of crisis, such as the COVID-19 pandemic. Thus, there is a need to improve their living conditions as society reemerges from the pandemic. Likewise, additional support should be given to LGBTQ+ students from lower-income households. Moreover, continuous monitoring of LGBTQ+ youths' life conditions and mental health post-quarantine is recommended.
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Affiliation(s)
- Jerome Visperas Cleofas
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
- Jerome Visperas Cleofas, 2401 Taft Avenue,
Malate, Manila 1004, Metro Manila, Philippines.
| | - Rowalt C. Alibudbud
- Department of Sociology and Behavioral Sciences, De La Salle University, Manila, Philippines
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21
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Kokay W, Power E, McGrath M. Mixed Study Systematic Review and Meta-analysis of Sexuality and Sexual Rehabilitation in LGBTQI+ Adults Living With Chronic Disease. Arch Phys Med Rehabil 2023; 104:108-118. [PMID: 35973583 DOI: 10.1016/j.apmr.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To systematically review how sexuality is experienced by lesbian, gay, bisexual, transgender, queer or questioning, intersex plus (other gender identifies and sexual orientations) (LGBTQI+) persons living with chronic disease. DATA SOURCES PsycINFO, Embase, MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health, and Web of Science were searched from date of inception to November 2021 for English language publications. Reference lists of relevant publications were also searched. STUDY SELECTION Eligible studies reported on sexuality among LGBTQI+ persons living with chronic disease. The search yielded 12,626 records; 665 full texts were assessed for eligibility and 63 documents included (59 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool. DATA EXTRACTION Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or with a third author. DATA SYNTHESIS A sequential, exploratory mixed-studies approach was used for synthesis. Pooled analysis indicated that among gay and bisexual men living with prostate cancer, 68.3% experienced erectile dysfunction and 62.9% had insufficient quality of erection to engage in anal sex. Among gay and bisexual men living with HIV or AIDS, 29.3% experienced loss of libido and 25.3% experienced erectile dysfunction. Although sexual dysfunction was common, LGBTQI+ persons had difficulty accessing appropriate sexual counseling and identified negative attitudes and heteronormative assumptions by health care providers as significant barriers to sexual health. Interventions to address sexuality focused entirely on reduction of risky sexual behavior among men living with HIV or AIDS. Women, transgender persons, and intersex persons were largely excluded from the research studies. CONCLUSIONS Current understandings of the effect of chronic disease on LGBTQI+ sexuality are limited and mostly focus on the male sexual response. LGBTQI+ persons who experience difficulty with sexuality struggle to identify appropriate services, and there is an absence of evidence-based interventions to promote sexual health and well-being in this population.
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Affiliation(s)
- William Kokay
- Sydney School of Health Sciences, University of Sydney, Sydney.
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney
| | - Margaret McGrath
- Sydney School of Health Sciences, University of Sydney, Australia
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22
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Pharr JR, Terry E, Wade A, Haboush-Deloye A, Marquez E. Impact of COVID-19 on Sexual and Gender Minority Communities: Focus Group Discussions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:50. [PMID: 36612372 PMCID: PMC9819493 DOI: 10.3390/ijerph20010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People who identify as sexual and gender minorities (SGM) experienced disproportionate economic and mental health issues related to COVID-19 when compared to the general population. The purpose of this study was to better understand how COVID-19 has impacted the SGM community and ways to address vaccine hesitancy. METHODS Three focus groups were conducted with 21 members of the SGM community between 5 November and 10 December 2020. A thematic analysis using the reflexive approach was applied to the transcripts of the focus groups. RESULTS Four themes emerged: (1) Impact of COVID-19 on the Community, (2) Perceptions of Contact Tracing and Testing, (3) Perceptions of a Potential COVID-19 Vaccine, and (4) Decreasing Vaccine Hesitancy. The most relevant subthemes were that social isolation led to anxiety, stress, and fear in the SGM community during COVID-19; resilience and adaptation were positive outcomes of the pandemic; histories of medical racism contributed to hesitancy to get tested; and specific messaging from trusted messengers may be needed to encourage SGM communities to get vaccinated. These findings support other COVID-19 research on the SGM community during the start of the pandemic. CONCLUSIONS This study provides insight into the impact of the early stages of COVID-19 on the SGM community, highlighting the unique hurdles faced by SGM individuals with regard to contact tracing and vaccine hesitancy.
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Affiliation(s)
- Jennifer R. Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
- Nevada Minority Health and Equity Coalition, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
- Nevada Minority Health and Equity Coalition, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
| | - André Wade
- Nevada Minority Health and Equity Coalition, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
- Silver State Equality, North Las Vegas, NV 89031, USA
| | - Amanda Haboush-Deloye
- Nevada Minority Health and Equity Coalition, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
- Nevada Institute for Children’s Research and Policy, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
| | - Erika Marquez
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
- Nevada Minority Health and Equity Coalition, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV 89119, USA
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Hadjiioannou E, Saadi JP. Queer minds, Queer needs. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2022. [DOI: 10.1080/13642537.2022.2156134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Julian-Pascal Saadi
- Specialist Counselling Psychologist, South London
- Maudsley NHS Foundation Trust
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Linardon J, Westrupp EM, Macdonald JA, Mikocka-Walus A, Stokes MA, Greenwood CJ, Youssef GJ, Teague S, Hutchinson D, Sciberras E, Fuller-Tyszkiewicz M. Monitoring Australian parents' shifting receptiveness to digital mental health interventions during the COVID-19 pandemic. Aust N Z J Psychiatry 2022; 56:1503-1514. [PMID: 34963330 DOI: 10.1177/00048674211065985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. METHOD The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. RESULTS More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child's mental health. Between-person baseline predictors of higher intention ratings were parent's prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child's education, lower social support and financial hardship. CONCLUSION Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need.
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Affiliation(s)
- Jake Linardon
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Elizabeth M Westrupp
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne Royal Children's Hospital, Melbourne, VIC, Australia
| | - Antonina Mikocka-Walus
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Mark A Stokes
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Samantha Teague
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne Royal Children's Hospital, Melbourne, VIC, Australia
- The National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne Royal Children's Hospital, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
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Huang MF, Chang YP, Lin CY, Yen CF. A Newly Developed Scale for Assessing Experienced and Anticipated Sexual Stigma in Health-Care Services for Gay and Bisexual Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13877. [PMID: 36360754 PMCID: PMC9658987 DOI: 10.3390/ijerph192113877] [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] [Received: 09/10/2022] [Revised: 10/09/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Gay and bisexual men's experiences and worries of sexual stigma by health-care providers may delay them from seeking health-care assistance. Our study developed the Experienced and Anticipated Sexual Stigma Scale in Health-care Services (EASSSiHS) and examined its psychometric properties. The six-item EASSSiHS was first developed on the basis of the results of focus group interviews with 24 participants. Parallel analysis was used to determine the number of factors. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure. The internal consistency was examined using McDonald's omega coefficient. Concurrent validity was examined using Pearson correlations with perceived sexual stigma from family and friends, depression, anxiety, and loneliness. The results of parallel analysis and EFA indicated that the factor structure of the EASSSiHS included two factors: experienced stigma and anticipated stigma. The result of CFA further confirmed the two-factor structure. The EASSSiHS had good internal consistency and acceptable concurrent validity. The anticipated stigma factor had stronger associations with perceived sexual stigma from family members and friends, depression, anxiety, and loneliness, when compared with the experienced stigma factor. The results of this study supported the psychometric properties of the EASSSiHS for assessing experienced and anticipated sexual stigma in health-care services among gay and bisexual men. The experience and worry of sexual stigma in health-care services were not rare among gay and bisexual men; therefore, interventions to enhance the cultural competency of health-care workers are urgently required.
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Affiliation(s)
- Mei-Feng Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14260, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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26
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Zhang W. Analysis of the Influence of Innovative Teaching Management Mode in Universities on Students' One-to-One Training and Psychotherapy. Occup Ther Int 2022; 2022:8505257. [PMID: 36304080 PMCID: PMC9581683 DOI: 10.1155/2022/8505257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study expects to investigate and verify the intervention effect of the university's innovative teaching management model on college students' resilience by implementing the university's innovative teaching management model for college students with low psychological resilience. Method The scientific scale is used to investigate the current level of college students' psychological resilience, and the development characteristics of college students' psychological resilience are obtained through statistical analysis. Based on the theoretical analysis of the application of psychological resilience intervention, combined with the theory of one-to-one tutoring and operational techniques, the university's innovative teaching management mode scheme is designed. The design adopts a quasi-experimental pre-experimental test to investigate and explore the intervention effect system of the university's innovative teaching management mode on college students' psychological resilience. In the intervention, each unit of activity is carried out in strict accordance with the established plan, and records and reflections are made at the end. One-to-one and face-to-face qualitative interviews were conducted with the subjects, and qualitative data were collected for qualitative analysis. Results/Discussion. Compared with the control group that did not receive the intervention, the psychological resilience of the subjects in the experimental group was significantly improved after receiving the intervention of the university's innovative teaching management model. The university's innovative teaching management model has a good intervention effect on the resilience of college students. The university's innovative teaching management model scheme compiled in this study integrates a variety of psychotherapy methods and combines one-to-one psychological counseling frameworks and techniques. It is an effective and easy-to-implement intervention scheme for college students' psychological resilience intervention.
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Affiliation(s)
- Wenwen Zhang
- School of Physical and Mathematical Sciences, Nanjing Tech University, Nanjing, Jiangsu 211816, China
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27
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Ş Kaya Ş, Calpbinici P. A discriminational attitude and behavior in the healthcare field: Homophobia level in healthcare professionals working in primary health services and the affecting factors. Perspect Psychiatr Care 2022; 58:2294-2302. [PMID: 35220597 DOI: 10.1111/ppc.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/05/2022] [Accepted: 02/12/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To investigate the homophobia level among the healthcare professionals working in primary healthcare services and the affecting factors. DESIGN AND METHODS This descriptive and cross-sectional study conducted between November 2018 and April 2019, included 184 healthcare professionals. FINDINGS The mean total score of the Hudson and Ricketts Homophobia Scale was 103.55 ± 30.47. There was a statistically significant difference between the marital status of the healthcare professionals, what they felt during the care/treatment of lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals, level of knowledge about such individuals, willingness to know more about them, and the status of having LGBTI acquaintances and the median homophobia score. PRACTICE IMPLICATIONS The results will be beneficial for LGBTI individuals, who have problems in communicating with primary healthcare personnel, to benefit from the services effectively.
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Affiliation(s)
- Şenay Ş Kaya
- Department of Nursing, Faculty of Semra and Vefa Küçük Health Sciences, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
| | - Pelin Calpbinici
- Department of Nursing, Faculty of Semra and Vefa Küçük Health Sciences, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
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28
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Llewellyn-Beardsley J, Rennick-Egglestone S, Pollock K, Ali Y, Watson E, Franklin D, Yeo C, Ng F, McGranahan R, Slade M, Edgley A. 'Maybe I Shouldn't Talk': The Role of Power in the Telling of Mental Health Recovery Stories. QUALITATIVE HEALTH RESEARCH 2022; 32:1828-1842. [PMID: 35979858 PMCID: PMC9511241 DOI: 10.1177/10497323221118239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mental health 'recovery narratives' are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing 'acceptable' stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience.
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Affiliation(s)
- Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | | | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Yasmin Ali
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Emma Watson
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Donna Franklin
- NEON Lived Experience Advisory Panel, University of Nottingham, Nottingham, UK
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | | | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Alison Edgley
- School of Health Sciences, University of Nottingham, Nottingham, UK
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29
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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.
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30
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 583] [Impact Index Per Article: 291.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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de Vries JMA, Downes C, Sharek D, Doyle L, Murphy R, Begley T, McCann E, Sheerin F, Smyth S, Higgins A. An exploration of mental distress in transgender people in Ireland with reference to minority stress and dissonance theory. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 24:469-486. [PMID: 37901058 PMCID: PMC10601524 DOI: 10.1080/26895269.2022.2105772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress.
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Affiliation(s)
- Jan M. A. de Vries
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Carmel Downes
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Danika Sharek
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Murphy
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Thelma Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Edward McCann
- Division of Nursing, City University of London, London, UK
| | - Fintan Sheerin
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Siobhán Smyth
- School of Nursing and Midwifery, National University Galway, Galway, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Televantos M, Strauss SM. “I wasn’t feeling like I belonged in my skin”: How self‐identified gay men in the
UK
experience unhelpful incidents in talking therapy
1. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Reynish T, Hoang H, Bridgman H, Nic Giolla Easpaig B. Barriers and enablers to mental health help seeking of sexual, gender, and erotic minorities: A systematic literature review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2036666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tamara Reynish
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Bróna Nic Giolla Easpaig
- Centre for Healthcare Resilience & Implement Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Miller RK, O’Neill D, Pua YK, Atkinson CM, Martin FH. Mental health literacy in India and Australia and its relationship to attitudes towards LGBT people. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2049630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Daniel O’Neill
- School of Psychology, The University of Newcastle, Ourimbah, NSW, Australia
| | - Yeow Khoon Pua
- School of Psychology, The University of Newcastle, Ourimbah, NSW, Australia
| | - Carmen M. Atkinson
- School of Psychology, The University of Newcastle, Ourimbah, NSW, Australia
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Brandt G, Prüll L, Paslakis G. Gesundheitliche Themen von LSBTIQ+Personen in der
ärztlichen Ausbildung in Deutschland. Psychother Psychosom Med Psychol 2022; 72:397-409. [PMID: 35287238 DOI: 10.1055/a-1758-0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Lesbian, gay, bisexual, trans, intersex and queer (LGBTIQ +) persons continue to experience discrimination and disadvantage in many areas of life, including healthcare. Studies indicate that LGBTIQ+persons show high rates of chronic physical and mental illness on the one hand, and report negative experiences with health care providers on the other hand. The aim of this work is to point towards barriers and the provision of inadequate health care for LGBTIQ+persons, and to draw attention to relevant gaps in medical education in Germany, needing to be followed by specific actions. METHODS For these purposes, both scientific evidence for the disadvantage of LGBTIQ+persons within the health care system and important innovative interventions in the education of medical personnel are presented and discussed. RESULTS A variety of different - in terms of scope, format, and content - training programs have already been tested and established, mainly in English-speaking regions of the world. In contrast, medical training in Germany lacks such programs. CONCLUSIONS Raising awareness and expanding the training of medical students to include LGBTIQ+health topics is of great importance in Germany.
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Affiliation(s)
- Gerrit Brandt
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Campus OWL, Ruhr-Universität Bochum Medizinische Fakultät, Lübbecke, Germany
| | - Livia Prüll
- Institut für Funktionelle und klinische Anatomie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Georgios Paslakis
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Campus OWL, Ruhr-Universität Bochum Medizinische Fakultät, Lübbecke, Germany
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Koene J, Zyto S, van der Stel J, van Lang N, Ammeraal M, Kupka RW, van Weeghel J. The relations between executive functions and occupational functioning in individuals with bipolar disorder: a scoping review. Int J Bipolar Disord 2022; 10:8. [PMID: 35286505 PMCID: PMC8921376 DOI: 10.1186/s40345-022-00255-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Patients with bipolar disorder experience impairments in their occupational functioning, despite remission of symptoms. Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia and are associated with diminished occupational functioning. Objectives The aim of this scoping review was to identify published studies that report on the relationships between executive functions and occupational functioning in BD to review current knowledge and identify knowledge gaps. In addition to traditional neuropsychological approaches, we aimed to describe executive functioning from a self-regulation perspective, including emotion regulation. Methods We applied the methodological framework as described by Arksey and O’Malley (Int J Soc Res Methodol Theory Pract 8:19–32, 2005) and Levac et al. (Implement Sci 5:1–9, 2010). We searched PubMed and psycINFO for literature up to November 2021, after which we screened papers based on inclusion criteria. Two reviewers independently performed the screening process, data charting process, and synthesis of results. Results The search yielded 1202 references after deduplication, of which 222 remained after initial screening. The screening and inclusion process yielded 82 eligible papers in which relationships between executive functions and occupational functioning are examined. Conclusion Neurocognitive deficits, including in executive functions and self-regulation, are associated with and predictive of diminished occupational functioning. Definitions and measurements for neurocognitive functions and occupational functioning differ greatly between studies, which complicates comparisons. Studies on functional remediation show promising results for improving occupational functioning in patients with BD. In research and clinical practice more attention is needed towards the quality of work functioning and the various contexts in which patients with BD experience deficits. Supplementary Information The online version contains supplementary material available at 10.1186/s40345-022-00255-7.
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Affiliation(s)
- Juul Koene
- University of Applied Sciences Leiden, Leiden, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | - Susan Zyto
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands. .,Mental Health Service Organisation North Holland North, Hoorn, The Netherlands.
| | | | | | - Marion Ammeraal
- GGZinGeest Center for Mental Health Care, Amsterdam, The Netherlands
| | - Ralph W Kupka
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands.,GGZinGeest Center for Mental Health Care, Amsterdam, The Netherlands
| | - Jaap van Weeghel
- Tranzo, Scientific Centre for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands.,Phrenos Center of Expertise, Utrecht, The Netherlands
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McDanal R, Rubin A, Fox KR, Schleider JL. Associations of LGBTQ+ Identities With Acceptability and Efficacy of Online Single-Session Youth Mental Health Interventions. Behav Ther 2022; 53:376-391. [PMID: 35227411 DOI: 10.1016/j.beth.2021.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/21/2022]
Abstract
Barriers such as stigma, financial costs, and provider shortages prevent large portions of youth with depression and related difficulties from accessing treatment; lesbian, gay, bisexual, transgender, queer/questioning sexual orientation, or other non-heterosexual identity (LGBTQ+) youth are burdened with additional barriers related to minority stress. Single-session interventions (SSIs) have been found to benefit youth and help reduce depression symptoms, and since many SSIs are brief, cost-free, and accessible online, they may circumvent several access barriers. However, prior to recommending non-community-tailored SSIs as a useful resource for minoritized youths, we first assessed whether LGBTQ+ youth respond as positively to SSIs as do cisgender heterosexual youth. In a subsample of youths recruited via online advertisements from September 2019 to August 2020 (N = 258, 81.4% female-assigned sex at birth, 60.5% LGBTQ+, 47.3% youth of color), we investigated whether changes in hopelessness, agency, and self-hate from before to after completing online self-directed SSIs differed as a function of LGBTQ+ identity. We also quantitatively and qualitatively compared intervention acceptability ratings and feedback across LGBTQ+ and cisgender heterosexual youths. Analyses revealed no significant differences between cisgender LGBQ+, trans and gender diverse, and cisgender heterosexual youths for any intervention outcomes. Likewise, no group differences emerged in intervention acceptability ratings or written program feedback. Self-selection bias and underrepresentation of certain populations, such as American Indian and Alaskan Native youths, may limit generalizability of results. Results suggest that online mental health SSIs are equally acceptable and useful to LGBTQ+ and cisgender heterosexual youth alike, even prior to culturally specific tailoring.
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Adolescent dropout from brief digital mental health interventions within and beyond randomized trials. Internet Interv 2022; 27:100496. [PMID: 35257001 PMCID: PMC8897204 DOI: 10.1016/j.invent.2022.100496] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Many adolescents struggle to access appropriate mental health care due to structural or psychological barriers. Although traditional barriers to participation (e.g., location, cost) are hypothetically reduced or removed in internet interventions, low retention reduces the likelihood that adolescents will receive the intervention dosage intended to produce beneficial effects. It is therefore key to determine what factors are associated with dropout in digital mental health interventions with adolescents both within and beyond the context of research studies. METHODS We compare completion rates from two projects evaluating self-guided, online single-session mental health interventions (SSIs) for adolescents. One was a randomized controlled trial (RCT) in which participants were paid for participation. The other was a program evaluation project in which participants were not paid for participation. We additionally compare SSI completion rates across various demographic groups and across baseline hopelessness levels. RESULTS There was a statistically significant difference in SSI completion status between the RCT (84.75% full-completers) and the program evaluation (36.86% full-completers), X 2 (2, N = 2436) = 583.5, p < 0.05. There were no significant differences in the baseline hopelessness scores across completion statuses in either study. There were no significant differences in full-completion rates across demographic groups in either project. CONCLUSION Adolescents may be more likely to complete a brief digital mental health intervention in a paid, research-based context than in an unpaid, naturalistic context. Additionally, it is possible that the brevity of SSIs reduces demographic disparities related to retention by minimizing the time required to complete an intervention.
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Problems and Countermeasures of College Students’ Mental Health Education. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6430855. [PMID: 35070241 PMCID: PMC8767377 DOI: 10.1155/2022/6430855] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022]
Abstract
Compared with the previous teaching environment and model, college students need more self-awareness and self-discipline to learn better. In order to solve many mental health problems of college students, this work studies that the school should increase policy support to relevant parties and strengthen the cultivation of college students’ psychological counseling ability, so as to provide more psychological counseling services for college students. This work studies and analyzes the common problems in contemporary college students’ mental health education, such as lack of teachers, mere formality, imperfect system, and poor pertinence, and puts forward the corresponding countermeasures for college students’ mental health education. When college students enter the university, they need to further improve their knowledge and ability to achieve professional development in a relatively loose learning environment. University is a key period for college students’ personality improvement and physical and mental development. With the increasing pressure of social employment, the psychological pressure of college students is increasing. This study provides a reference for the mental health problems of college students.
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Anson C, Zhong HMJ, Wilby KJ. Advancing the conversation: A review of scholarly activity for curricular interventions for sexually- and gender-diverse patients in pharmacy education. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1718-1723. [PMID: 34895684 DOI: 10.1016/j.cptl.2021.09.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/26/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Educational interventions are required to train pharmacists to provide culturally safe care to sexually- and gender-diverse patients. Programming must promote inclusivity and should also focus on systemwide change. The aim of this review was to identify, summarize, and map scholarly activity with respect to lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) health in entry-to-practice pharmacy curricula. METHODS An electronic search of Medline, EMBASE, and International Pharmaceutical Abstracts was conducted to search for relevant literature up to May 2021. This search was supplemented with a keyword search of three pharmacy education journals. Articles were included in the review if they described an educational intervention for entry-to-practice pharmacy students related to health for sexually- or gender-diverse patients. RESULTS Five articles met inclusion criteria. All articles reported interventions relating to gender-diverse patients. One reported interventions relating to sexually-diverse patients and another was deemed unclear. Four articles reported single teaching events or short modules, and one article reported a full course. Incorporating real patients into teaching events to share their experiences with the health system was consistently received positively by students. IMPLICATIONS Scholars involved in developing and implementing educational interventions related to health for sexually- and gender-diverse patients should be encouraged to contribute to the scholarly conversation by sharing successful experiences, as well as lessons learned. Future areas of expansion include integration of sexual and gender minority health across curricula and including content to prepare students for implementing and supporting systemwide change.
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Affiliation(s)
- Casey Anson
- School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | | | - Kyle John Wilby
- College of Pharmacy, Faculty of Health, Dalhousie University, PO Box 15000, 5968 College Street, Halifax, Nova Scotia B3H 4R2, Canada.
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LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111366. [PMID: 34769885 PMCID: PMC8582806 DOI: 10.3390/ijerph182111366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.
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Carthy E, Hillier B, Tracy DK, Pakianathan M, Morris S, Shell Y, Forrester A. Chemsex-related crime and vulnerability: A public health and criminal justice priority. MEDICINE, SCIENCE, AND THE LAW 2021; 61:247-249. [PMID: 34558363 DOI: 10.1177/00258024211049490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Elliott Carthy
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Bradley Hillier
- West London Forensic Service, St Bernard's Hospital, West London NHS Trust, UK
| | - Derek K Tracy
- West London NHS Trust, UK
- Department of Psychosis Studies, the Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
- Division of Psychiatry, University College London, UK
| | | | - Stephen Morris
- Her Majesty's Prison & Probation Service (HMPPS), London, UK
| | - Yvonne Shell
- Department of Psychology, Bournemouth University
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Buspavanich P, Lech S, Lermer E, Fischer M, Berger M, Vilsmaier T, Kaltofen T, Keckstein S, Mahner S, Behr J, Thaler CJ, Batz F. Well-being during COVID-19 pandemic: A comparison of individuals with minoritized sexual and gender identities and cis-heterosexual individuals. PLoS One 2021; 16:e0252356. [PMID: 34101746 PMCID: PMC8186787 DOI: 10.1371/journal.pone.0252356] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic. METHODS Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression). RESULTS Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being. CONCLUSION Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.
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Affiliation(s)
- Pichit Buspavanich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Sexology and Sexual Medicine, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sonia Lech
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Medical Sociology and Rehabilitation Science, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Eva Lermer
- Center for Leadership and People Management, LMU Munich, Munich, Germany
- FOM University of Applied Sciences of Economics and Management, Essen, Germany
| | - Mirjam Fischer
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Maximilian Berger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Till Kaltofen
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Simon Keckstein
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Joachim Behr
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany
| | - Christian J. Thaler
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Falk Batz
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
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Lea T, Brener L, Lambert S, Whitlam G, Holt M. Treatment outcomes of a lesbian, gay, bisexual, transgender and queer alcohol and other drug counselling service in Australia: A retrospective analysis of client records. Drug Alcohol Rev 2021; 40:1358-1368. [PMID: 33951245 DOI: 10.1111/dar.13303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/23/2021] [Accepted: 04/10/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Substance use disorders are more prevalent among lesbian, gay, bisexual, transgender and queer (LGBTQ) people than among their heterosexual and cisgender peers. There has been limited alcohol and other drug (AOD) treatment research with LGBTQ people outside of North America. This study aimed to examine the treatment outcomes of clients attending a LGBTQ-specific AOD counselling service in Australia (ACON's Substance Support Service) and compare their client profile and treatment outcomes with LGBTQ and non-LGBTQ clients of similar mainstream services. METHODS This study was a retrospective analysis of the health records of 284 ACON clients and 1011 clients of five mainstream services in 2016-2018. Clients completed clinical interviews at treatment entry and periodically throughout treatment and completed measures of substance use, severity of dependence, psychological distress and quality of life. RESULTS Most ACON clients were seeking treatment for methamphetamine (58%) and alcohol use (26%). Among ACON clients, there were reductions in past month days of substance use and severity of dependence between treatment entry and counselling sessions 4, 8 and 12 (all P < 0.001). There were statistically significant reductions in psychological distress and improved quality of life among ACON clients. Despite ACON and the mainstream services having similar treatment approaches, their client profiles were markedly different in terms of sociodemographic characteristics, substance use and source of referral, which precluded comparison of treatment outcomes. DISCUSSION AND CONCLUSIONS ACON's clients showed reduced substance use and improved psychosocial wellbeing during treatment. The findings support the provision of LGBTQ-specific AOD services.
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Affiliation(s)
- Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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