Multiple methods findings from a systematic scoping review and qualitative interviews to inform LGBTQ+ affirming practices for nursing education.

Abstract

<h4>Background</h4>Lesbian, gay, bisexual, transgender and other gender and sexual minority people (LGBTQ+) individuals face dramatic inequities in health outcomes across the US and especially those residing in the Deep South due to pervasive LGBTQ+-related stigma and discrimination. A significant barrier repeatedly noted is the lack of clinicians trained to provide LGBTQ+-affirming care. Given that nurses play a critical role in patient care, research was needed to inform the development and piloting of LGBTQ+-specific curriculum for nursing faculty.<h4>Methods</h4>We conducted a multiple-methods study consisting of a PRISMA-ScR-guided scoping review and qualitative descriptive interviews. A systematic search of PubMed identified studies relevant to LGBTQ+ nursing education, and 62 articles met criteria for inclusion and thematic synthesis. To further contextualize these findings, we conducted individual qualitative interviews with nursing students and faculty (<i>n</i> = 21) to explore experiences with LGBTQ+-related curriculum and instructional practices.<h4>Results</h4>Our multiple-methods results fall into two broad domains: (1) Course content (i.e., LGBTQ+-focused theories, evolving terms and concepts, empirical evidence of health inequities, and clinical considerations); (2) Considerations on how best to deliver the course (i.e., balancing hybrid modalities, varying lengths, balancing personal and lived experience among instructors, and minimal costs, and use of validated scales in combination with qualitative questions for the evaluation).<h4>Discussion and conclusion</h4>Given the substantial number of LGBTQ+ people across the US (2024 Gallup Poll shows 9.3% of the country's population identifies as LGBTQ+), and especially in the South (home to the largest LGBTQ+ population across Census Bureau regions), we are unlikely to 'make America healthy again' without addressing the needs of LGBTQ+ communities. To do so, structural-level change that engages the providers in our health systems, and specifically the nurses who have the most touchpoints with our patients, is needed to reconcile the promise of good health and its achievement. Our results provide a clear roadmap to educating our nursing faculty and empowering them to deliver on our collective commitment to achieve the highest attainable standard of health for all.