Nursing students' care of and attitudes towards lesbian, gay, bisexual, trans, and intersex people in times of COVID-19 in Spain: A cross-sectional study.

OBJECTIVE: The objective of this work is to measure the knowledge and attitudes of Catalan nursing students regarding lesbian, gay, bisexual, trans, and intersex (LGBTI) patients, as well as their perception of specific training in this area, according to their internship modalities, sociodemographic circumstances, and academic background during the COVID-19 pandemic. BACKGROUND: During the COVID-19 pandemic, the Spanish Government created the "Health-Aid" internship: A paid alternative to curricular internships. There is extensive evidence that paid work environments perpetuate negative attitudes towards LGBTI patients. METHOD: A cross-sectional survey aimed at Catalan nursing students. The "Attitudes Towards and Knowledge About Lesbian, Gay, Bisexual, Trans and Intersex Patients" questionnaire was adapted. A descriptive study and backward regression models were constructed. RESULTS: Three hundred thirty-seven students, mean age 23.80 years (SD: 5.17) participated; 85% women and 54 (16%) completing the Health Aid internship modality. More than 50% did not attend specific training on the care of the lesbian, gay, bisexual, trans, and intersex population. Differences between internship modalities showed higher values in the curricular internship group: Attitudes (U = 6526.50, p = .031) and training perception (U = 5926.50, p = .008). CONCLUSIONS: Nursing students' attitudes towards lesbian, gay, bisexual, trans, and intersex patients and their perception of specific training on care for this population were negatively influenced by the paid Health Aid internship during the pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Even under dire circumstances, clinical training must be properly managed to address the specific health needs of vulnerable populations, such as lesbian, gay, bisexual, trans, and intersex patients. Paid internships in emergency scenarios may impede these objectives.

Gender differences in the decision-making process for undergoing total knee replacement.

OBJECTIVE: To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). METHODS: A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making process, treatment preference and TKR uptake 6 months later were compared by gender. Multivariate regression models were developed to identify gender-specific predictors. RESULTS: Women showed less knowledge (MD = -7.68, 95% CI: -13.9, -1.46, p = 0.016), reported less satisfaction (MD = -6.95, 95% CI: -11.7, -2.23, p = 0.004) and gave more importance to avoiding surgery (U = 2.09, p = 0.019). In women, more importance attributed to the time needed to relieve symptoms significantly reduced the odds of surgery (OR = 0.76, p = 0.016). CONCLUSION: The provision of information and/or promotion of shared decision-making could be of lower quality in female patients, although other explanations such as differences in information needs or preference for involvement in decision-making cannot be ruled out with the current evidence. Given the study's limitations, especially regarding the sample size, further confirmation is needed. PRACTICE IMPLICATIONS: A systematic, shared decision-making approach in consultation is needed to avoid potential gender-based biases.