Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study
Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study
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DOI：
10.1016/j.whi.2014.08.003
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发表时间：
2014-11-01
影响因子：
3.2
通讯作者：
Nemeth, Lynne S.
中科院分区：
文献类型：
--
作者：
Johnson, Michael J.;Nemeth, Lynne S.
背景：女同性恋者和双性恋者妇女在公平的保健服务方面遇到许多障碍，例如缺乏高质量的保健和歧视性的保健环境。这些障碍影响了当地妇女的福祉，大概导致了卫生和保健方面的差距。尽管存在这些差异，但很少有已发表的研究探讨LB妇女的健康服务。这项定性的、扎根的理论研究解决了这一差距。方法：采用有目的的抽样方法招募18至24岁的女性，她们被确认为LB，并报告成年后使用卫生服务。参与者(n=9)是从美国西南部大学的女同性恋、男同性恋、双性恋和变性人学生团体中招募的，并进行了深入的录音访谈。这9位参与者代表了29种独特的医疗保健体验。这些记录被上传到NVivo，并使用持续比较的方法对数据进行分析。结果：确定了六个主题，包括寻求医疗保健、期望、性取向的披露、真相时刻(提供者属性)、最近结果和健康结果。这些主题被分类到一个解释性的概念框架中，该框架代表了医疗保健体验的三个不同阶段：前期互动、医疗互动和结果。结论：本研究中的女性将性取向和提供者属性的披露视为医疗保健体验的主要点。创建性取向公开性取向的卫生保健环境和教育提供者适当的保健是可能影响妇女健康和保健差距的战略。版权所有(C)2014年，由雅各布斯妇女健康研究所所有。由爱思唯尔公司出版。
Background: Lesbian and bisexual (LB) women encounter numerous barriers to equitable health care services, such as lack of quality care and discriminatory health care settings. These barriers affect the well-being of LB women, presumably leading to disparities in health and health care. Despite these disparities, few published research studies explore health services of LB women. This qualitative, grounded theory study addressed that gap.Methods: Purposive sampling was used to recruit 18- to 24-year-old women who identified as LB and who reported using health services as an adult. Participants (n = 9) were recruited from lesbian, gay, bisexual, and transgender student groups at universities in the Southwestern United States, and in-depth audio recorded interviews were performed. The nine participants represent 29 unique health care experiences. The transcriptions were uploaded into NVivo, and the constant comparison method was used to analyze the data.Findings: Six themes were identified, including seeking health care, expectations, disclosure of sexual orientation, moment of truth (provider attributes), proximal outcomes, and health outcomes. These themes were sorted into an explanatory conceptual framework that represents three distinct phases of the health care experience: Pre-interaction, health care interaction, and outcomes.Conclusions: The women in this study identified disclosure of sexual orientation and provider attributes as major points in the health care experience. Creating health care environments that facilitate disclosure of sexual orientation and educating providers about LB-appropriate care are strategies that may impact health and health care disparities of LB women. Copyright (C) 2014 by the Jacobs Institute of Women's Health. Published by Elsevier Inc.