Abstract
Introduction: Individuals may belong to different sexual minorities. Such a personal circumstance should not influence the quality of healthcare. Yet, many face discrimination due to their sexual orientation, while the healthcare system is typically heteronormative. The objective of this integrative review was to provide a synthesis of research evidence on the experiences of lesbian, gay, bisexual and transgender (LGBT) individuals with healthcare professionals.Methods: An integrative literature review was employed, and codes and categories were identified. A literature search was performed in the databases Springer Link, SAGE, CINAHL, Academic Search Elite and MEDLINE. The key words used were: "experiences", "healthcare", "gay patient experiences", "gay", "lesbian", "homosexual", "bisexual" and "transgender". Primary sources were selected according to inclusion and exclusion criteria. Thematic analysis was conducted with an open coding of the results of selected sources. Results: A total of 6,839 studies were screened from June to August 2018 and 14 (published between 2009 and 2017) were selected for the final analysis. The results yielded 41 codes, combined into two categories termed: 'Positive experiences of LGBT individuals with healthcare professionals' and 'Negative experiences of LGBT individuals with healthcare professionals'.Discussion and conclusion: The experiences of LGBT individuals with healthcare professionals are ambivalent. Although positive experiences prevail, negative ones should not be overlooked as they are derived from heteronormativity and sometimes even prejudice and homophobia. Healthcare professionals need cultural competences which reflect the developments in a society and the needs of its individuals.
Highlights
Individuals may belong to different sexual minorities
Positive experiences are connected to openness, nonjudgment, acceptance and support (Eady, et al, 2011); to acceptance, consideration and respect of sexual orientation or gender identity (Lyons, et al, 2015); to privacy protection, confirmation of sexual orientation or gender identity, and absence of irritating questions (Hoffkling, et al, 2017); they included acceptance, non-judgment, honesty, warmth, care, professionalism, calmness, kindness, listening, sensitivity, and empathy (Victor & Nel, 2016); and they refer to professionalism, a willingness to help, knowledge, care, respect, and compassion (Riggs, et al, 2014)
We have found that experiences of individuals with various sexual orientations with healthcare professionals are ambivalent
Summary
Individuals may belong to different sexual minorities. Such a personal circumstance should not influence the quality of healthcare. Many face discrimination due to their sexual orientation, while the healthcare system is typically heteronormative The objective of this integrative review was to provide a synthesis of research evidence on the experiences of lesbian, gay, bisexual and transgender (LGBT) individuals with healthcare professionals. The revised International Council of Nurses (ICN) Code of Ethics for Nurses explicitly states in its preamble that "nursing care is respectful of and unrestricted by considerations of " gender and sexual orientation (ICN, 2012). This means that gender identity and sexual orientation is a personal circumstance which cannot influence the quality of provided nursing care in any way. After the year 2000, research evidence on attitudes towards individuals with various sexual orientations in healthcare has revealed less standard homophobia, an increase in tolerance and acceptance, and less judging, but still a certain degree of distance (Rondahl, et al, 2004)
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