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QUAL WOM
The580
LGBTQ E
ITY EN Me
Journa
ducation: Earn Your “A”
The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community is estimated to represent 3.5% of the adult popu- lation in the United States, roughly 9 million people.1 A substantial proportion of that number are people who identify as female. This group suffers significant health disparities linked to a long-standing history of discrimination, stigmatization, and the denial of many civil rights.2 LGBTQ populations experience high rates of substance abuse, suicide, mental health
CARE FOR ’S HEALTH gan Spiekermeier,
DNP, WHNP
disorders, homelessness, obesity, sexually transmitted infections (STIs), and violence.1-4
LGBTQ persons are less likely to seek preven- tive services due to lack of insurance coverage or fear of stigmatization and discrimination.1
Women already face significant health disparities based on sexism; intersecting forms of discrim- ination (homophobia, transphobia, stigmatiza- tion, or even ambivalence) can compound the negative effects on women’s physical and mental health and overall well-being.5 Results from the Lambda Legal Health Care Fairness Survey revealed that respondents who identified as female within the LGBTQ population surveyed were more likely than their nonfemale coun- terparts to experience barriers to health care services, discrimination, and incompetent care.5
In the survey, female respondents were most affected by the denial of infertility services and taxation of same-sex partner benefits.5 There were greater percentages of female respondents
l for Nurse Practitioners – JNP
that reported being treated differently than other people at health care appointments and who felt that health care providers were unaware of LGBTQ-specific needs.5 Many female respondents cited barriers to care including: insufficient numbers of health care professionals trained to care for LGBTQ people; the possibility of being refused care based on gender identity or sexual orientation; and the fear of mistreatment.5 These barriers can lead to reluctance to seek care, and thus, poorer health outcomes for LGBTQ individuals and families.
Healthy People 2020 established a goal to “improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender individu- als.”2(p1) Although increased societal acceptance and legal nondiscrimination policies have improved access to health care and insurance for the LGBTQ community, policies do not guar- antee provider competence or freedom from discrimination.1 Despite recommendations from several expert panels for LGBTQ cultural competency training for health care profes- sionals, traditional medical and nursing education curricula provide limited to no content on LGBTQ issues.3 As a result, there is a shortage of clinicians who are knowledgeable and culturally competent in LGBTQ health.
Nurses comprise the largest portion of direct patient care providers and are often the first health care provider a patient encounters. Yet, nurses report that they do not feel comfortable or prepared to care for LGBTQ patients and desire additional education.4 As leaders in the nursing profession, advanced practice registered nurses could address the needs of the LGBTQ community. Proper training and education on gender and sexual minorities could foster trusting patient- provider relationships, increase identification of gender and sexual minority patients, and in- crease provider competency in assessment and diagnosis of health care problems impacting LGBTQ persons. By decreasing barriers to
Volume 13, Issue 8, September 2017
w
care, more LGBTQ persons may seek pre- ventive health services, have more confidence in the health care system, and live healthier and longer lives. Addressing gaps in education may benefit the LGBTQ population and the com- munity at large in the form of increased quality and quantity of life, reduction in disease transmission and progression, and decreased health care costs.2 For these reasons, it is imperative that the nursing profession take action within education institutions, health policy, and within communities to insure inclusive and culturally competent care for the LGBTQ population. The National LGBT Education Center of the Fenway Institute offers many online training, education, and resources for healthcare institutions to integrate into their programs.6 To aid in the integration of LGBTQ education into nursing curricula, national nursing standards and competencies should reflect stronger language or mandates for the inclusion of LGBTQ cultural competency training. Together these recommendations will likely improve nursing competencies in LGBTQ care and create a competent nursing workforce across all health care settings.
In conclusion, nursing has long been the most trusted profession that places the utmost importance on the role of patient advocate, yet, we have failed in our ethical responsibility to address the needs of our LGBTQ patients and families. As criteria for defining sexual orientation, gender identity and expression continue to evolve, letters are
ww.npjournal.org
being added to the acronym. The letter “A” has begun to appear to stand for “ally” to acknowledge those that stand ready to support the LGBTQ community. By advo- cating for strong LGBTQ content in health profession curricula, advanced practice regis- tered nurses could enable more clinicians to be prepared to apply evidence-based best practice for this vulnerable population and earn their “A.”
References
1. Kates J, Ranji U, Beamesderfer A, et al. Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the U.S. The Henry J. Kaiser Family Foundation. November 11, 2016. http://kff.org/disparitiespolicy/issue-brief/health-and-access-to-care -and-coverage-for-lesbian-gay-bisexual-and-transgender-individuals -in-the-u-s/. Accessed May 23, 2017.
2. Healthy People 2020. Lesbian, gay, bisexual, and transgender health. https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian -gay-bisexual-and-transgender-health/. Accessed May 23, 2017.
3. Lim FA, Brown DV, Kim SM. Addressing health care disparities in the lesbian, gay, bisexual, and transgender population: a review of best practices. Am J Nurs. 2014;114(6):24-34.
4. Carabez R, Pellegrini M, Mankovitz A, et al. “Never in all my years.”: nurses’ education about LGBT health. J Prof Nurs. 2015;31(4): 323-329.
5. Lambda Legal. When health care isn’t caring: LGBT women. 2010. http://www.lambdalegal.org/sites/default/files/publications/ downloads/whcic-insert_lgbt-women.pdf/. Accessed May 23, 2017.
6. National LGBT Education Center: Fenway Institute. What we offer. https://www.lgbthealtheducation.org/about-us/lgbt-health-education/. Accessed May 23, 2017.
Megan Spiekermeier, DNP, WHNP, is a recent graduate of the ASU Women’s Health NP program. She can be reached at m.spiek14@gmail.com. Department Editor Denise G. Link, PhD, WHNP, FAAN, FAANP, who would like to hear your ideas for future columns, can be reached at deniseg.link@gmail.com.
1555-4155/17/$ see front matter © 2017 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.nurpra.2017.05.091
The Journal for Nurse Practitioners – JNP 581
Reproduced with permission of copyright owner. Further reproduction prohibited without
permission.
The post The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community is estimated to represent 3.5% of the adult popu- lation in the United States, roughly 9 million people.1 A substantial proportion of that number are people who identify as female. appeared first on Infinite Essays.
Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates
Tania Israel University of California, Santa Barbara
Cathleen E. Willging Pacific Institute for Research and Evaluation,
Albuquerque, New Mexico
David Ley New Mexico Solutions, Albuquerque, New Mexico
Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in rural areas experience negative mental health consequences of minority stress, and encounter multiple barriers to accessing mental health and substance use treatment services. As part of a larger intervention study, we developed and piloted a unique training program to prepare peer advocates for roles as paraprofessionals who assist rural LGBTQ people with mental health needs. Thirty-seven people in New Mexico took part in either the initial training or a second revised training to improve their knowledge and skills to address LGBTQ mental health needs. Evaluation of this training consisted of self- administered structured assessments, focus groups, and open-ended interviews. Results for the initial training showed no significant increases from pre- and posttest scores on knowledge about LGBTQ people and their mental health issues, whereas significant increases were detected for the revised training. There also were significant increases in self-efficacy to perform tasks associated with the peer advocate role for all but a subset of tasks for the revised training. Qualitative data reveal that participants appreciated the opportunity to increase information and skills, especially concerning bisexual and transgender persons, and the opportunity to connect with others in the community who want to support LGBTQ people.
Keywords: LGBTQ, mental health, peer, rural, training
Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people in the United States experience tremendous mental health and substance use disparities (Institute of Medicine, 2011). High rates of depression, anx- iety, and suicidality within the LGBTQ popula- tion may originate in “minority stress,” which comprises chronic stigma, discrimination, and
violence (Meyer, 2003). Minority stress oper- ates within cultural institutions and social struc- tures, including health care systems (Meyer, 2003; Meyer, Schwartz, & Frost, 2008), and may disproportionately affect gender noncon- forming individuals, people of color, and rural LGBTQ persons (Díaz, Bein, & Ayala, 2006; McLaughlin, Hatzenbuehler, & Keyes, 2010; Pinhey & Millman, 2004; Williams, Bowen, & Horvath, 2005).
With regard to rural communities, LGBTQ people may face social pressure to adhere to tra- ditional gender roles and norms (Barefoot, Rick- ard, Smalley, & Warren, 2015), as well as nega- tive attitudes related to lack of contact with sexual and gender minorities (Barefoot et al., 2015; El- dridge, Mack, & Swank, 2006; Herek, 2002; Sniv- ely, Kreuger, Stretch, Watt, & Chadha, 2004). Victimization—verbal harassment, property dam- age, and physical assault—is commonly reported by rural LGBTQ people (Barefoot et al., 2015;
Tania Israel, Department of Counseling, Clinical, and School Psychology, University of California, Santa Bar- bara; Cathleen E. Willging, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico; David Ley, New Mexico Solutions, Albuquerque, New Mexico.
The project described in this article was supported by NIMH R34MH095238.
Correspondence concerning this article should be ad- dressed to Tania Israel, Department of Counseling, Clinical, and School Psychology, Gevirtz School, University of Cal- ifornia, Santa Barbara, CA 93106-9490. E-mail: tisrael@ education.ucsb.edu
The post Development and Evaluation of Training for Rural LGBTQ Mental Health Peer Advocates appeared first on Infinite Essays.
Evidence – Based Practice- Ethics in Research
Description: The nurse differentiates between ethical and legal precepts that guide research,
protect human subjects and guide unique population-based interventions.
Course Competencies: 3) Differentiate between ethical and legal precepts that guide research
conduct and protect human subjects. 5) Evaluate data from relevant sources, including
technology, to inform the delivery of care to culturally and ethnically diverse populations.
QSEN Competencies: 3) Evidence-Based Practice 5) Safety
BSN Essential III
APA, Grammar,
Spelling, and
Punctuation
No errors in APA,
Spelling, and
Punctuation.
One to three errors
in APA, Spelling,
and Punctuation.
Four to six errors
in APA, Spelling,
and Punctuation.
Seven or more
errors in APA,
Spelling, and
Punctuation.
References Provides two or
more references.
Provides two
references.
Provides one
references.
Provides no
references.
Area Gold
Mastery
Silver
Proficient
Bronze
Acceptable
Acceptable
Mastery not
Demonstrated
Differentiates
between legal and
ethical
considerations and
the role of the IRB
Differentiates
between legal and
ethical
considerations and
the role of the IRB
Discusses ethical
and legal
considerations but
does NOT discuss
the IRB’s role
Discusses the
IRB’s role but
does NOT discuss
legal and ethical
considerations
Does not discuss
legal and ethical
considerations or
the IRB’s role
Demonstrates
knowledge of
Research History,
Codes, respect for
person,
beneficence, and
justice
Utilizes
knowledge of
Research History,
Codes, respect for
person,
beneficence, and
justice when
discussing
vulnerable
populations and
IRB
Utilizes most of
the concepts (2/3)
Research History,
Codes, respect for
person,
beneficence, and
justice when
discussing
vulnerable
populations and
IRB
Utilizes most of
the concepts (1/2)
Research History,
Codes, respect for
person,
beneficence, and
justice when
discussing
vulnerable
populations and
IRB
Identifies a
vulnerable
population of
interest but does
not relate to
research principles
Identifies diverse
populations in
research and
supports the need
for ethical
considerations
assertions with
sound rationale
Analyzes the need
for diverse
populations in
research.
Supports
assertions with
sound rationale
Analyzes the need
for diverse
populations in
research.
However, does not
support any
assertions.
Defines diverse
populations but
does not discuss
research needs.
Discusses only the
needs for ethical
precepts when
designing
research. Does
not analyze the
need for diverse
populations in
research.
The post Description: The nurse differentiates between ethical and legal precepts that guide research, protect human subjects and guide unique population-based interventions. appeared first on Infinite Essays.
We are experienced and have access to ample research materials to guarantee quality A+ papers. Our Professional Writers can handle all subjects and deliver your papers on time.
For any questions, feedback, or comments, we have an ethical customer support team that is always waiting on the line for your inquiries.
Send us an E-mail: support@homeworkhandlers.com or Call us: +1 (518)-934-6741
