A Survey of Nursing Students' Knowledge of and Attitudes toward LGBT Health Care Concerns

By Cornelius, Judith B.; Carrick, Jennifer | Nursing Education Perspectives, May-June 2015 | Go to article overview

A Survey of Nursing Students' Knowledge of and Attitudes toward LGBT Health Care Concerns


Cornelius, Judith B., Carrick, Jennifer, Nursing Education Perspectives


Abstract

While LGBT individuals represent almost 10 percent of the population in the United States, many clinicians have inadequate knowledge to care for these sexual minority groups. The purpose of this study was to examine nursing students' knowledge of and attitudes toward providing care to LGBT individuals. A 73-item survey was administered to a sample of 190 nursing students. Findings indicated significant knowledge deficits, with RN-BSN students more knowledgeable and having more positive attitudes toward providing LGBT health care than other students. Supplementary teaching strategies may be needed to help students become more comfortable in providing care to LGBT individuals.

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More than 8 million adults in the United States identify as lesbian, gay, or bisexual, and almost 700,000 identify as transgender (Gates, 2012). These numbers represent more than 3.4 percent of the adults in the population (Gates). Some reports suggest that the number is as high as 10 percent (Lim & Levitt, 2011) as many lesbian, gay, bisexual, and transgender (LGBT) individuals do not disclose their sexual preference.

A national groundbreaking report released by the Institute of Medicine

(IOM) (2011) noted that clinicians have inadequate knowledge of LGBT health care. The report pointed to the need for greater understanding of LGBT health issues by health care providers and, consistent with the goals of the Affordable Care Act (ACA), emphasized access to quality health care for LGBT persons. Healthy People 2020 (US Department of Health and Human Services [DHHS], 2013) has set forth goals for eliminating health care disparities and providing equal access to health care for all patients.

LGBT individuals continue to face many barriers to receiving care, including lack of access to appropriate health services and a lack of sensitive health care professionals, especially nurses (Eliason, Dibble, & Dejoseph, 2010). In a study of transgender and nonconforming individuals (Grant, Mottet, & Tanis, 2010), 19 percent of respondents indicated that they were refused care due to their transgender or gender-nonconforming status; 28 percent reported being harassed in medical settings; 50 percent reported a lack of provider knowledge about their health care needs; 28 percent postponed seeking medical care when sick or injured due to discrimination; and 48 percent delayed seeking medical care due to their inability to afford it. Clearly, a lack of compentent, knowledgeable, and sensitive health care providers has resulted in less than optimal care and poorer health outcomes for LGBT individuals (IOM, 2011; DHHS, 2013).

KNOWLEDGE OF AND ATTITUDES TOWARD LGBT CARE

To our knowledge, only three published studies have examined nursing students' knowledge of and attitudes toward LGBT health care. An early study by Rondahl, Innala, and Carlsson (2006) found that 36 percent of staff nurses and 9 percent of nursing students would refuse to provide care for homosexual patients if that option were available. In a more recent study, Rondahl (2009) examined 124 Swedish medical and nursing students' knowledge of the unique health care needs of LGBT patients and identified "shortcomings" in their knowledge. Two years later, Rondahl (2011) conducted another study with five nursing students and three medical students to examine heteronormativity in health care education programs. The nursing students felt that nurse educators were not proactive in addressing issues of LGBT patients and heteronormativity was prominent in both the nursing and medical programs.

As health care providers, nurses have an obligation to be knowledgeable about and sensitive to the health care needs of marginalized individuals. If curricula do not prepare them to provide optimal care, then health disparities will continue to exist for LGBT individuals. A first step in ensuring that nurses have this sensitivity is to examine nursing students' current knowledge and attitudes toward LGBT health care concerns. …

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