LGBTQ Cultural Competency for Nurses

The health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) people has recently become a national health priority. The National Institute of Health (NIH) declared LGBTQ communities a health disparity population in October of 2016 (NIH, 2016). Many advances in policy (same-sex marriage, visitation rights, etc.) and societal shifts have allowed for increased visibility of this community in our society, but has healthcare and nursing kept up? In 2011, then Secretary of State, Hillary Rodham-Clinton discussed how LGBT rights are human rights and that health advocates, researchers, and practitioners engage in a "more proactive role in bridging health disparity among the "invisible minority" (Lim et al, 2013, p. 198)". The National Institutes of Health designated the LGBTQ community as a "health disparity population" for research, citing provider knowledge and attitudes as one of the key areas needing further research.

Within nursing curricula and research, heterosexual bias still exists that diminishes LGBTQ nursing care. From 2005 to 2009, only eight out of 5,000 nursing articles where published that focused on LGBTQ health issues (Strong & Folse, 2015). The Department of Health and Human Services found that the LGBTQ population is at an increased risk of suicide, depression, HIV infection, sexually transmitted diseases, obesity, and alcohol and drug abuse (Traynor, 2016). What further exacerbates these health disparities is that LGBTQ patients also face minority stress – "stress that is experienced by individuals from stigmatized social categories as a result of inferior social status (Strong & Folse, 2015, p. 45)". One of the largest barriers to culturally congruent LGBTQ care is the lack of knowledge on LGBTQ people and possible negative attitudes among nurses and providers (Strong & Folse, 2015).

The purpose of this study is to establish a baseline understanding of the knowledge and attitude of registered nurses about LGBTQ people as well as measure the impact of a newly designed educational intervention on their knowledge and attitudes.

The research questions guiding this project are 1) what is are the existing levels of knowledge and attitude that inpatient registered nurses have about the LGBTQ community and 2) what is the impact newly designed LGBTQ focused educational intervention on inpatient registered nurses’ knowledge and attitudes?

The design of this study is modelled after the original research of Strong et al. It is a descriptive correlational study with a cross-sectional design with pretest/posttest methodology. The design allows for exploration of various variables of demographics and the pre/post test scores on the knowledge and attitudes of LGBT people and health. Variables examined look at their encounters with LGBT people, previous education on LGBT health, age, education level, and nursing experience.

Participants in the study will be informed that their participation is completely voluntary and that they may withdraw at any time as well as confidentiality of their responses. The only perceived benefits for the participants are to broaden their knowledge about LGBTQ and their care of the LGBTQ patient. There are no associated risks with the study other than the potential for moral conflict with the subject data.

The knowledge and attitudes of the registered nurses will be measured utilizing three validated tools – the modified Attitudes Toward Lesbians and Gay Men (ATLG) scale, the Attitudes Toward Lesbian, Gay, Bisexual and Transgender Patients (ATLGBTP) scale, and the Knowledge of Lesbian, Gay, Bisexual, and Transgender People KLGBT questionnaire.

Descriptive statistics will be utilized to analyze the demographics of the study participants (mean, standard deviation, and range).

The mean scores of the pretest/posttest will be analyze through a t-test for comparison of the dependent variable and independent and through the use of ANOVA for more than three independent variables.