"Treat us with dignity": a qualitative study of the experiences and recommendations of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients with cancer

被引:80
|
作者
Kamen, Charles S. [1 ]
Alpert, Alison [1 ]
Margolies, Liz [2 ]
Griggs, Jennifer J. [3 ]
Darbes, Lynae [3 ]
Smith-Stoner, Marilyn [4 ]
Lytle, Megan [1 ]
Poteat, Tonia [5 ]
Scout, N. F. N. [6 ]
Norton, Sally A. [1 ]
机构
[1] Univ Rochester, Saunders Res Bldg,265 Crittenden Blvd,Box 420658, Rochester, NY 14642 USA
[2] Natl LGBT Canc Network, New York, NY USA
[3] Univ Michigan, Ann Arbor, MI 48109 USA
[4] Calif State Univ San Bernardino, San Bernardino, CA 92407 USA
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
[6] Torvus Grp, Beverly Hills, CA USA
关键词
Cancer; Sexual orientation; Gender identity; Health disparities; Sexual and gender minorities; HEALTH-CARE; BREAST-CANCER; SELF-ADVOCACY; PSYCHOLOGICAL DISTRESS; SEXUAL ORIENTATION; SOCIAL SUPPORT; DISPARITIES; DISCLOSURE; PROVIDERS; WOMEN;
D O I
10.1007/s00520-018-4535-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PurposeDespite indications that lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients have unique needs when seeking healthcare, the experiences of LGBTQ patients in the context of cancer care have not been fully explored. This qualitative study investigated recommendations offered by LGBTQ patients with cancer for improving cancer care.MethodsTwo hundred seventy-three LGBTQ people across the USA who had been diagnosed with cancer completed an online survey that included open-ended questions. Using responses to these questions, two researchers independently conducted open coding. A code book was generated collaboratively and the data were coded independently. Codes were clustered and refined and the data were independently re-coded.ResultsFive themes emerged. LGBTQ patients with cancer: (1) are affected by providers' LGBTQ-specific knowledge and skills, assumptions, and mistreatment; (2) negotiate disclosure of identities based on safety of clinical encounters; (3) have differing experiences based on multiple intersecting identities; (4) receive more effective care when members of their support networks are included; and (5) are self-advocates and undergo transformative experiences in the face of morbidity and marginalization.ConclusionsLGBTQ cancer survivors report challenges accessing competent cancer treatment. To address this, cancer care providers should provide safe clinical encounters, inquire about and respond professionally to patients' identities and identifiers, include chosen support people, provide care relevant to patients' gender identities, and address treatments' effects on sexuality. Training providers about diverse LGBTQ communities and acknowledging the strengths of LGBTQ patients with cancer may improve provider/patient relationships. Provider training could be created based on these principles.
引用
收藏
页码:2525 / 2532
页数:8
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