Identify, Engage, Understand: Supporting Transgender Youth in an Inpatient Psychiatric Hospital
Identify, Engage, Understand: Supporting Transgender Youth in an Inpatient Psychiatric Hospital
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DOI：
10.1007/s11126-019-09653-0
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发表时间：
2019-09-01
影响因子：
3.5
通讯作者：
van Schalkwyk, Gerrit Ian
中科院分区：
文献类型：
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作者：
Acosta, William;Qayyum, Zheala;van Schalkwyk, Gerrit Ian
跨性别青少年可能需要住院精神病治疗，并且有独特的医疗保健需求，并且可能面临高质量护理的障碍。本研究旨在解决对跨性别青少年住院经历的有限理解。本研究使用定性的方法来深入了解跨性别青少年和精神科护理提供者在美国东北部青少年住院精神科的经验。对患者（共9名，年龄13-17岁）和单位护理提供者（共18名）进行了半结构化访谈。这些访谈被记录、转录，并使用归纳主题分析进行分析。患者和提供者普遍报告了一个支持性的住院环境。促成这种环境的因素是护理提供者努力尊重患者，而不考虑性别认同，使用患者首选的标识符，并承认标识符使用中的错误。我们还发现了持续支持性互动的障碍，包括在入院时缺乏以支持性方式对患者跨性别身份的一致识别，与护理系统中存在出生指定姓名和性别相关的挑战（例如，在电子病历、识别腕带、出勤名册中），以及缺乏对护理提供者进行跨性别文化能力的正式培训。访谈还提供了对提供者如何努力理解性别认同的复杂性的见解。研究结果表明，提供者的性别肯定方法对跨性别青少年患者来说是支持和尊重的，同时也确定了持续支持互动的障碍，可以解决这些障碍以优化护理。
Transgender adolescents may require for inpatient psychiatric care, and have unique healthcare needs and can face barriers to quality care. This study sought to address limited understanding of the inpatient experience of transgender adolescents. This study uses qualitative methods to gain insight into the experience of transgender adolescents and psychiatric care providers on an adolescent inpatient psychiatric unit in the northeast United States. Semi-structured interviews were conducted with patients (9 total, ages 13-17) and unit care providers (18 total). These interviews were recorded, transcribed, and analyzed using inductive thematic analysis. Patients and providers generally reported a supportive inpatient environment. Factors that contributed to this environment were efforts by care providers to respect patients regardless of gender identity, to use patient's preferred identifiers, and to acknowledge mistakes in identifier use. Barriers to consistently supportive interactions were also identified, including a lack of consistent identification of a patient's transgender identity in a supportive manner during the admission intake, challenges associated with the presence of birth-assigned name and gender within the care system (e.g. in the electronic medical record, identifying wristbands, attendance rosters), and a lack of formal training of care providers in transgender cultural competency. Interviews also provided insight into how providers grapple with understanding the complexities of gender identity. Findings suggest that gender-affirming approaches by providers are experienced as supportive and respectful by transgender adolescent patients, while also identifying barriers to consistently supportive interactions that can be addressed to optimize care.