Defining and researching the concept of resilience in LGBT+ later life: Findings from a mixed study systematic review.

Within the literature, resilience is described as either a trait, an outcome or a process and no universal definition exists. A growing body of research shows that older LGBT+ adults show signs of resilience despite facing multiple inequalities that negatively impact their health and social wellbeing. The aim of this review was to examine how resilience is defined in LGBT+ ageing research and how it is studied. A mixed-study systematic search of peer-reviewed research papers published before June 2022 was conducted using the electronic databases CINAHL, Embase, Medline, PsycInfo, Social Science Database and Web of Science. This resulted in the screening of 7101 papers 27 of which matched the inclusion criteria. A quality appraisal was conducted using the Mixed Methods Appraisal Tool. Findings show that papers often lack a clear definition of resilience and application of resilience theory within the studies, although many of the papers conceptualised resilience as either a trait, process or an outcome. However, resilience was rarely the primary focus of the studies and was researched using a variety of measurement instruments and conceptual frameworks. Given the socioeconomic disparities, diverse social relations, histories of discrimination and stigma, and acts of resistance that have shaped the lives of older LGBT+ populations, resilience is a topic of growing interest for researchers and practitioners. Clear definitions of resilience and application of resilience theory could help improve methods used to study the concept and lead to more robust findings and the development of effective interventions. Greater clarity on the concept of resilience could also broaden the focus of research that informs policies and practice, and support practitioner training in resilience and the particular experiences of older LGBT+ adults.

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review.

AIM(S): To report review findings into interventions used to educate the health and social care workforce on the experiences and needs of LGBT+ older adults. BACKGROUND: Research demonstrates that inequalities in outcomes on health and social well-being for LGBT+ older adults are perpetuated by the cumulative disadvantages from discrimination and social exclusion throughout the life course and a lack of culturally competent workforce. METHODS: A systematic search of peer-reviewed papers published before February 2020 was conducted in electronic databases. The search resulted in a screening of 2,509 papers with nine matching the inclusion criteria, which were rated using the MERSQI quality measure. RESULTS: Studies demonstrated some positive outcomes of interventions, especially an increase in knowledge, but less so in skills and attitudes. DISCUSSION: More robust designs such as randomized controlled trials, the use of standardized measures and a focus more on the longitudinal impact of educational interventions could improve the quality of study designs. CONCLUSION(S): Diversification of intervention content and patient and public involvement in the design, delivery and evaluation of educational interventions could improve efforts and have a more sustained impact on LGBT+ ageing inequalities. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers have important roles in supporting staff education and ensuring LGBT+ inclusive practice.

Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: Findings from a systematic review.

BACKGROUND: There is a growing awareness of the need for LGBT + competency training to ensure that the health and social care services offered to older LGBT + people is affirmative and gender sensitive. OBJECTIVE: To conduct a synthesis of the literature that describes the pedagogical principles, curriculum content and methods (teaching and assessment) used to educate health and social care practitioners on the experiences and needs of older LGBT + people. DESIGN: Systematic thematic review of literature. DATA SOURCES: MEDLINE, CINAHL, PsycINFO, EMBASE, Web of Science, Social Sciences Index, ERIC. METHOD: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined peer-reviewed papers published in English, prior to April 2018 that addressed pedagogical and curriculum issues on the inclusion of needs and experiences of older LGBT + people. RESULTS: The combined searches yielded 2214 papers of which 17 papers were eligible for inclusion, 10 discussion papers and 7 evaluation studies. Analysis identified the following themes: i) Acknowledging the wider historical context of older LGBT + people's lives; ii) Recognising that older LGBT + people are not a homogenous group; iii) Incorporating a multitude of theories and models from different perspectives; iv) Alerting practitioners to the health issues and disparities facing older LGBT + people; v) Including content that supports inclusive care for older LGBT + people; vi) Addressing barriers to older LGBT + people accessing health care; vii) Interactive activities are the preferred pedagogical strategy; viii) Involving older LGBT + people in curriculum development is a core principle; and ix) Mandatory education is not always the solution. CONCLUSION: As the field matures there is a need for more exploration of curriculum principles, assessment strategies and strategies to overcome barriers to the inclusion of issues experienced by older LGBT + people within curricula.