Healthcare Preferences of Lesbian, Gay, Bisexual, Transgender and Questioning Youth
Healthcare Preferences of Lesbian, Gay, Bisexual, Transgender and Questioning Youth
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DOI：
10.1016/j.jadohealth.2009.01.009
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发表时间：
2009-09-01
影响因子：
7.6
通讯作者：
Swann, Stephanie
中科院分区：
文献类型：
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作者：
Hoffman, Neal D.;Freeman, Katherine;Swann, Stephanie
目的：女同性恋、男同性恋、双性恋、跨性别和质疑（LGBTQ）青年似乎面临某些不良健康结果的更高风险，并且在获得医疗保健方面存在一些个人、文化和结构性障碍。然而，关于LGBTQ青年在医疗保健提供者和医疗保健服务中的经历，我们所知甚少。我们的目标是招募一个LGBTQ青年样本，并确定他们对医疗保健提供者、医疗保健环境和他们认为与医疗保健提供者讨论的重要健康问题的偏好。方法：我们进行了一项基于互联网的横断面调查。年龄在13-21岁、居住在美国或加拿大的受访者被要求回顾与医疗保健提供者的质量、办公室或医疗中心的质量以及与医疗保健提供者讨论的关注点或问题有关的三个项目列表，然后为每个项目分配一个相对重要性。然后对三个列表中的每个项目进行排名，并评估排名之间的差异。还评估了年龄、性别和种族/民族的组间差异。结果：733名青年符合入选标准。青年被认为是最重要的能力，特别是在照顾青年和LGBTQ人群的独特问题上，以及得到与其他青年一样的尊重和对待。值得注意的是，年轻人的性别和性取向是最不重要的。青年认为无障碍问题高于所提供的具体服务。在与医生讨论健康问题时，年轻人认为预防性保健、营养、安全性行为和家庭与常见疾病同等重要。结论：青少年对服务提供者的素质和人际交往能力的重视程度与服务提供者的知识和经验相当，而对服务提供者的性别和性取向的重视程度较低。青年指出，提供者不仅要处理健康风险，而且要处理健康和促进健康的问题，而且要在家庭和家庭的背景下这样做。亚组分析强调需要对LGBTQ青年的文化和发展差异更加敏感。这些结果为进一步研究青少年的医疗服务和提供系统、医疗服务提供者的培训计划，以及利用互联网为健康研究目的访问和招募难以接触的青少年的作用提供了基础。(c) 2009年青少年医学会。版权所有。
Purpose: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth appear to be at higher risk for certain adverse health outcomes, and to have several personal, cultural and structural barriers to accessing healthcare. Little is known, however, about the experiences of LGBTQ youth with healthcare providers and healthcare services. Our goal was to recruit a sample of LGBTQ youth and to determine their preferences regarding healthcare providers, healthcare settings and the health issues that they consider important to discuss with a healthcare provider.Methods: We conducted a cross-sectional Internet-based survey. Respondents ages 13-21 years and living in the U.S. or Canada were asked to review three lists of items pertaining to qualities of healthcare providers, qualities of offices or health centers, and concerns or problems to discuss with a healthcare provider, and then to assign for each item a relative importance. Items in each of the three lists were then ranked, and differences among ranks were assessed. Inter-group differences by age, gender, and race/ethnicity were also assessed.Results: 733 youth met eligibility criteria. Youth indicated as most important competence overall and specifically in issues unique to taking care of youth and LGBTQ persons, as well as being respected and treated by providers the same as other youth. Notably, youth ranked as least important the provider's gender and sexual orientation. Youth ranked accessibility issues higher than specific services provided. As health concerns to discuss with a provider, youth ranked preventive healthcare, nutrition, safe sex, and family as important as common morbidities.Conclusions: Youth placed as much importance on provider qualities and interpersonal skills as provider knowledge and experience, and placed little importance on a provider's gender and sexual orientation. Youth indicated the importance of providers addressing not only health risks, but also wellness and health promotion, and to do so within the context of home and family. Subgroup analyses underscore the need for greater sensitivity to both cultural and developmental differences among LGBTQ youth. These results provide a foundation for further research about healthcare services and delivery systems for youth, training initiatives for healthcare providers, and the role of utilizing the Internet for health research purposes to access and recruit hard-to-reach youth. (c) 2009 Society for Adolescent Medicine. All rights reserved.