Oncology healthcare providers’ knowledge, attitudes, and practice behaviors regarding LGBT health

Abstract

Objective There are limited data on lesbian, gay, bisexual, and transgender (LGBT) health and healthcare experiences. An important part of healthcare experiences are interactions with the provider. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. Methods A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey was divided into five sections: demographics, knowledge, attitudes, practice behaviors, and open comments. Results 108 providers participated in the survey (28% response rate). Less than 50% answered the knowledge questions. 94% stated they were comfortable treating this population. 26% actively inquired about a patient’s sexual orientation when taking a history and 28% felt they were well informed on the health needs of this population. 36% felt the need for mandatory education on LGBT cultural competency at the institution. Results from the open comments section identified key themes such as the need for increased oncology provider education and a misconception that inquiring about a patient’s sexual orientation/gender identity wasn’t necessary. Conclusion This study revealed knowledge gaps about LGBT health risks in the majority of providers surveyed. Cultural competency training may aid oncology providers to understand the need to know a patient’s gender identity and sexual orientation. Practice Implications Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Providers who are aware of LGBT status of their patients may offer education, counseling and referrals for reduction of risk behaviors.

Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care

“…The survey was constructed based on prior studies (Arseneau, Grzanka, Miles, & Fassinger, 2013;Crisp, 2006;Shetty et al, 2016;Walch, Ngamake, Francisco, Stitt, & Shingler, 2012) and included the following measures:…”

“…The beliefs measure was adapted from the Sexual Orientation Beliefs Scale (Arseneau et al, 2013), the Attitudes Toward Transgendered Individuals Scale (Walch et al, 2012), and attitudes regarding LGBT health (Shetty et al, 2016) and consisted of 12 statements addressing beliefs about sexual orientation, sex, and gender, comfort in treating LGBT populations, belief of unique health risks, belief in more medical education, and belief that the LGBT population is more difficult to treat. All items were scored on a 5-point Likert type scale with 1 (strongly disagree) to 5 (strongly agree).…”

“…In a recent study assessing knowledge, attitudes, and practice behaviors of oncology HCPs regarding LGBT health at a single institution, results indicated significant knowledge gaps with less than 50% HCPs answering knowledge questions correctly (Shetty et al, 2016). Whereas 94% stated they were comfortable treating LGBT population, only about a quarter actively inquired about a patient's sexual orientation when taking a history, and just over a third felt the need for mandatory education on LGBT cultural competency at their institutions (Shetty et al, 2016).…”

“…Whereas 94% stated they were comfortable treating LGBT population, only about a quarter actively inquired about a patient's sexual orientation when taking a history, and just over a third felt the need for mandatory education on LGBT cultural competency at their institutions (Shetty et al, 2016). Although Shetty and colleagues (2016) did not find significant differences in knowledge, attitudes, and practice behaviors regarding LGBT health by demographic characteristic of HCPs, other studies have demonstrated that some demographic characteristics (e.g., personal or professional contact with LGBT persons, female, self-identification as LGBT) are associated with more positive attitudes about LGBT patient health care (e.g., Banwari, Mistry, Soni, Parikh, & Gandhi, 2015;Dorsen, 2012;Grabovac, Abramović, Komlenović, Milosević, & Mustajbegović, 2014;Lapinski, Sexton, & Baker, 2014).…”

Culturally Competent Care for Sexual and Gender Minority Patients at National Cancer Institute-Designated Comprehensive Cancer Centers

“…Medical providers, in general, receive limited information about SGM health issues, 28 and oncology providers specifically report gaps in knowledge concerning SGM patient needs. 29 Creating an environment where SGM patients, their friends, and families feel safe and included is an important task for cancer centers seeking to improve the experiences of their patients. Our findings suggest that the most common method that institutions in this study use to convey an inclusive welcoming environment for SGM populations is to include SOGI in nondiscrimination policies (e.g., patient bill of rights) and post these policies so that they are visible to patients.…”