Care Needs, Challenges, and Experiences of Sexual and Gender Minority Cancer Survivors in Taiwan: Findings from a Qualitative Study.

OBJECTIVES: This study aimed to explore the care needs, challenges, and experiences of cancer care among sexual and gender minority (SGM) cancer survivors in Taiwan. METHODS: Semi-structured interviews were conducted face-to-face or telephonically with 30 SGM cancer survivors in Taiwan. Data were analyzed using the socio-ecological model and the constant comparative technique. The study used the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULTS: The needs, challenges, and experiences of cancer care among SGM cancer survivors were categorized and presented according to the level of the social-ecological model: (1) intrapersonal level: physical and psychological impacts and changes in outlook on life after cancer diagnosis and treatment; (2) interpersonal level: informal social support resources and challenges for developing intimate relationships; (3) community level: formal social support resources and lack of SGM support groups; and (4) societal and policy level: positive and negative experiences with oncology healthcare providers (HCPs), sexual orientation disclosure, and lack of an SGM-friendly environment. CONCLUSIONS: Multilevel care needs and challenges in cancer care among SGM cancer survivors were identified. Oncology HCPs should be aware of and assess SGM cancer survivors' psychosexual issues and psychological status and provide suitable care resources to individuals. Moreover, training courses on culturally competent cancer care and information on SGM-related health policies (including same-sex marriage) should be provided to oncology HCPs to improve their sensitivity, knowledge, and skills to provide suitable care for SGM cancer survivors. IMPLICATIONS FOR NURSING PRACTICE: The study findings can be used to design and develop training courses for culturally competent cancer care for oncology HCPs to improve the quality of care and reduce cancer care disparities among SGM cancer patients.

Taiwanese nurse educators' behaviour or intention to teach LGBT health content: A qualitative study.

AIM: To explore factors associated with Taiwanese nurse educators' behaviour or intention to teach lesbian, gay, bisexual and transgender (LGBT) health content. BACKGROUND: Nurse educators were found to have limited experiences and readiness to teach LGBT health content. However, limited evidence exists to comprehensively understand factors associated with nurse educators' behaviour and intentions to teach LGBT health content. METHODS: A qualitative descriptive study design was adopted. A total of 24 nurse educators were interviewed. One-on-one interviews were conducted employing a semi-structured topic guide and were audio-recorded. Interview data were analysed using the socio-ecological model and constant comparative technique. This article was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. FINDINGS: Most nurse educators had no experience of teaching LGBT health content and expressed their low or no intention to teach it. Factors associated with nurse educators' behaviour and intention to teach LGBT content were categorised by the socio-ecological model level: intrapersonal factors, interpersonal factors, community factors and societal and policy factors. CONCLUSION: This study identified multilevel factors associated with Taiwanese nurse educators' behaviour and intention to teach LGBT health content. Recommendations were provided to address multilevel barriers to diminish nurse educators' challenges in teaching LGBT health content. IMPLICATIONS FOR NURSING AND NURSING POLICY: Supervisors of nurse educators should assess and discuss nurse educators' concerns and competencies regarding teaching LGBT health content. To address schools' or organisations' adverse climates and conventional societal atmosphere, related policies and regulations should be developed and implemented.

Enhancing cultural competence in caring for lesbian, gay, bisexual, and transgender patients: An online training program for Taiwanese student nurses and nurses.

BACKGROUND: Health disparities exist among lesbian, gay, bisexual, and transgender (LGBT) populations worldwide. However, student nurses and nurse staff have limited knowledge and skills in providing culturally competent nursing care for LGBT patients in Taiwan. OBJECTIVES: This paper describes the development, implementation, and evaluation of an online training program for the cultural competence of student nurses and nurses in Taiwan. DESIGN: A one-group pre-/post-test study design. SETTINGS: The study was conducted in five nursing schools, 10 nursing associations, and 37 long-term care facilities. Two prominent online bulletin boards (PTT Nurse and Dcard Nurse) and one Taiwanese nursing group on Facebook were used to recruit participants. PARTICIPANTS: In total, 301 student nurses and nurses participated in the study and responded to pre- and post-test questionnaires. METHODS: An online training program for culturally competent nursing care was developed and implemented. The pre- and post-test questionnaires contained three sections: (1) demographics, (2) knowledge of LGBT health, and (3) the Sexual Orientation Counselor Competency Scale. Three open-ended questions were included in the post-test questionnaire to evaluate the online training program. RESULTS: The online training program significantly improved the participants' knowledge and cultural competence skills. However, their attitudes towards cultural competence did not change after the program was implemented. Regarding qualitative feedback of the online training program, feedback on the strengths and limitations of the program was summarized under three themes: program content, website design, and online modules. CONCLUSIONS: The results suggest the importance of an online training program which may contribute to reducing health disparities among the LGBT population.

Attitudes toward, knowledge of, and beliefs regarding providing care to LGBT patients among student nurses, nurses, and nursing educators: A cross-sectional survey.

BACKGROUND: Studies have assessed attitudes toward, knowledge of, and beliefs regarding providing care for lesbian, gay, bisexual, and transgender (LGBT) patients among student nurses, nurses, and nursing educators individually, but few studies have compared these aspects among these groups. OBJECTIVES: To examine the attitudes toward, knowledge of, and beliefs regarding providing care for LGBT patients among student nurses, nurses, and nursing educators in Taiwan. DESIGN: Cross-sectional survey. SETTINGS: The study was advertised in 8 nursing schools, 14 nursing associations, 209 nursing homes, and 2 online chatrooms in Taiwan. PARTICIPANTS: A total of 1150 participants were recruited: 447 student nurses, 475 nurses, and 228 nursing educators. METHODS: Data were collected between August 2021 and January 2022 through a questionnaire with five sections: demographics, knowledge of LGBT health, the Knowledge about Homosexuality Questionnaire, the Attitude Toward Lesbian and Gay Men Scale, and the Gay Affirmative Practice Scale. RESULTS: The results suggest that the participants had limited knowledge of LGBT health. The nursing educators had the lowest scores for knowledge of LGBT health and homosexuality and the most negative attitudes toward lesbians and gay men among the groups; however, they were most likely to report their beliefs regarding providing nursing care to LGBT patients than the other two groups. CONCLUSIONS: The results indicate the importance of providing nursing educators with training courses and resources related to culturally competent care to improve education for nursing students and care for LGBT patients.