Transgender and Gender Nonconforming in Emergency Departments: A Qualitative Report of Patient Experiences.
Transgender and Gender Nonconforming in Emergency Departments: A Qualitative Report of Patient Experiences.
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DOI：
10.1089/trgh.2016.0026
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Shearer, Peter L
中科院分区：
文献类型：
--
作者：
Chisolm-Straker, Makini;Jardine, Logan;Shearer, Peter L
背景：有跨性别或性别不一致（TGGNC）经历的个人属于美国人口的边缘部分，医疗保健对他们来说很难驾驭。虽然急诊科（EDs）传统上是弱势群体的医疗保健“安全网”，但美国以外的定量研究发现，有tggnc经历的人倾向于避免急诊科和/或有负面经历。这项定性研究主要描述了有TGGNC病史的人的ED经历；此外，该研究还探讨了这一人群避开美国急诊科的原因以及他们对改善急诊科护理的建议。方法：本定性研究采用回顾性、匿名、书面调查（论文或基于网络）的tggnc病史患者在美国急诊室的经历数据。国家数据收集从2012年6月到2014年12月。采用主题分析对参与者的回答（n=240）进行了检查。结果：在一个识别积极和消极反应的框架下，自我效能感和权力不平等的主题浮出水面。这些主题暴露了具有TGGNC经验的患者与被认为缺乏这方面培训的临床医生之间的紧张关系，从而导致患者的负面体验。当从业人员对这一人群进行了专门的培训时，参与者报告了积极的护理经历。结论：本研究表明，许多有tggnc病史的患者在使用美国急诊科时都有不良经历，这主要是由于医生对这一患者群体缺乏敏感性和培训。这项调查的数据表明，对美国急诊科医生的培训和机构支持将有助于改善对这一边缘化群体的护理。
Background: Individuals who have a transgender or gender nonconforming (TGGNC) experience belong to a marginalized segment of the U.S. population, and healthcare can be difficult for them to navigate. Although emergency departments (EDs) traditionally serve as healthcare "safety nets" for vulnerable populations, quantitative studies outside the United States have found that TGGNC-experienced persons tend to avoid EDs and/or have negative experiences. This qualitative study primarily describes the ED experiences of people with a TGGNC history; furthermore, the study explores reasons why this population avoids U.S. EDs and their recommendations for improvements to ED care. Methods: This qualitative study used data about TGGNC-historied persons' experiences in U.S. EDs from retrospective, anonymous, written surveys (paper or web based). National data collection took place from June 2012 through December 2014. Participant responses (n=240) were examined using thematic analysis. Results: Using a framework that recognized positive and negative responses, the themes of Self-Efficacy and Power Inequity surfaced. These themes exposed the tension between patients with TGGNC experiences and clinicians who were perceived to lack training in this area, resulting in negative patient experiences. When practitioners had specific training about this population, participants reported positive care experiences. Conclusions: This study indicates that many TGGNC-historied persons who use U.S. EDs have negative experiences, largely due to lack of provider sensitivity toward and training about this patient population. Data from this investigation suggest that training of U.S. ED providers and institutional support would help improve care for this marginalized group.