The purpose of this mixed methods study was to explore and identify the beliefs, behaviors, and experiences of APRNs with lesbian and gay patients. This study used a convergent parallel design. A sample of 678 APRNs from a northeastern state completed the survey - a 30-item, Gay Affirmative Practice (GAP) Likert-type scale, 13 demographic items and a narrative description of experiences of having cared for lesbian and gay patients. Quantitative data were analyzed using descriptive statistics and ANOVA. Qualitative data were analyzed using Krippendorff’s analytic technique of clustering units to form themes. Social constructionism was the theoretical perspective that guided this study and pragmatism was the philosophical perspective that informed the methodology. ANOVA indicated statistically significant (p ≤ .005) differences in GAP scale scores based on personal identity, having a lesbian or gay family member, political party, practice place, practice focus, and number of lesbian and gay patients. Eight thematic categories emerged from APRN experiences: affirming, more education needed, witnessed discrimination, limited experience with lesbian/gay patients, sexual orientation only asked if relevant, treat all the same, non-affirming, and sexual orientation not focus of practice. The thematic categories of affirming, have witnessed discrimination, and more education needed consistently had the highest GAP scale scores compared to the others.
This study has helped to lay a foundation for understanding the beliefs, behaviors and experiences of APRNs who have cared for lesbian and gay patients. Results will inform health care providers to demonstrate greater individualized care for patients who are lesbian and gay, and inform nursing education, practice, policy, and future research aimed to support culturally appropriate and affirming care for these patient populations.