Nurse Practitioners' Barriers and Facilitators to Providing Lesbian, Gay and Bisexual Inclusive Care

Purpose: Research shows that LGB individuals experience significant healthcare disparities compared to heterosexuals. Although the reasons are multifactorial, negative attitudes towards LGB patients among healthcare providers may be a key factor. There is a paucity of literature on nurses’ attitudes towards LGB patients, and there has never been a study on NP attitudes towards LGB patients. The purpose of this qualitative study was to explore the attitudes and experiences of NPs working with LGB patients in NYC.

Methods: This study used Corbin & Strauss’ grounded theory methodology. Semi-structured interviews with experts in LGBT health (n=3) and LGB patients (n=6) informed the final interview guide used with a sample of 19 NPs working in primary/outpatient care. NPs were recruited via publically available lists and snowball sampling. A three step analysis procedure culminated in the conceptual framework: NPs multiple facilitators and barriers to providing LGB inclusive care.

Results: The resulting framework reflects the complexity of the multiple, often overlapping, influences on attitudes and intention to provide LGB inclusive care and includes 5 factors: 1) NPs baseline passive intention to provide inclusive care, 2) facilitators to providing care, 3) barriers to providing care, 4) active intention to provide care and 5) education and experience needed to provide LGB inclusive care.

Conclusion: Consideration of the barriers and facilitators NPs face when providing LGB inclusive care will help educators, researchers and policy makers understand the complex interplay of factors in attitude development and intention to provide LGB inclusive care, with the goal of reducing health disparities.