Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Dr. Keisha Fallin-Bennett

Committee Member

Dr. Lynn Jensen

Abstract

Purpose: The specific aim of this study was to identify the LGBT patient’s perspective of what factors could contribute to a more responsive primary care environment.

Methods: The study was a non-experimental, descriptive study utilizing an anonymous, internet based electronic survey. A survey/questionnaire tool, developed for the study, was disseminated among a social media site and a listserv for two organizations with strong connections to the LGBT community.

Results: Eighty-one responses were received. Participants: 60% identified as female, 95% were Caucasian, with 84% never having a Pap smear, and only 6.6% having recommended breast cancer screenings. The incidence of those who received HIV and Hepatitis C screening were 13.2 and 7.2% respectively. Participants identified the following factors as facilitators to accessing healthcare non-judgmental and non-heterosexist/genderist attitudes of staff (15%), feelings of confidentiality (14.5%) and safety (14%), and provider knowledge of the LGBT community (12%). Barriers to care were apparent when LGBT patients were met with judgmental, heterosexist attitudes, feelings of a deficient level of safety, lack of confidentiality and limited cultural competence and knowledge of the LGBT patient by providers. The results were a major factor leading to non-disclosure. Improving health care outcomes among this population is dependent on providers gaining cultural competency to improve communication and awareness of LGBT health issues.

Conclusion: Improving social and structural gaps that lead to non-disclosure of sexual orientation and gender identity as perceived by the LGBT community is essential to decreasing health disparities in this population. The survey results infer that although there is progress being made with acceptance of the LGBT population, there continue to be modifiable barriers associated with patient-provider relations.

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