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Angela Purgiel
There is a severe knowledge deficit related to the lesbian, gay, bisexual, and transgender (LGBT)
population and health care. The Unites States health care system does not have the tools nor the
education it needs to properly serve this community. With the implementation of an education
program using the Precede-Proceed model, nursing students can be better equipped to properly
care for the LGBT population. Through the use of case studies and simulation labs the nursing
students can gain exposure to real life situations and translate their education to real life
The more research that is conducted on the lesbian, gay, bisexual and transgender
(LGBT) population the larger the identified need is. With health disparity statics at an alarming
all time high, intervention related to health care education is greatly needed. LGBT youth are 2
to 3 times more likely to attempt suicide and LGBT youth are more likely to be homeless, to
name a few ("LGTB," 2014). With nurses at the forefront of caring for this population it is
imperative to ensure adequate education is available to nursing students across the Unites States.
The care delivery model that would most likely aid in the planning and evaluation to
improve health for this population is the Precede-Proceed model. This care delivery model fit
best because it is the easiest to understand and is important to the overall success of the
implementation of this vulnerable population. This care delivery model was also selected
because the underlying fundamental disposition is that “health and health risks are caused by
multiple factors and because of this, efforts to impact change must be multidimensional” (Cupp
Curley & Vitale, 2012, p. 169). This is important for this population because solutions will be
multidimensional as the factors influencing this population are complex. There are many factors
influencing the overall health of this population, for example discrimination and victimization,
There are five steps that need to be addressed in order to implement education for this
population.
Step 1 Determine population needs- “As the health care needs of the lesbian, gay,
bisexual, and transgender (LGBT) population become increasingly important, health care
professionals require appropriate academic and clinical training in preparation for the increased
demand for culturally competent care” (Lim, Brown, & Jones, 2013, p. 198).
CARE DELIVERY MODEL 4
Step 2 Identify health determinants of these needs- “The Institute of Medicine’s (IOM,
2011) consensus report highlighted the lack of science-based knowledge on the health of LGBT
individuals owing to the lack of research in LGBT health and the U.S. Department of Health and
Human Service further underscored the existence of health disparities and the lack of
compassionate services for LGBT individuals” (Lim et al., 2013, p. 199). Other barriers affecting
this population are access to adequate to health insurance, employment, housing, marriage,
Step 3 Analyze behaviors and environment determinants of health needs- “Many surveys
that are administered on national and state levels do not collect demographic data on sexual
orientation or gender identity, thus making it difficult to acquire an accurate sense of how many
individuals in the United States identify as LGBT (Lim et al., 2013, p. 200). Along with the lack
available surveys there is also a fear to admit to being a member of LGBT for fear of
discrimination.
has been criminalized and pathologized throughout history. Although homosexuality was
declassified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders in
1973 repercussions are still felt today”. This is also influenced by the “prevalence of mental
disorders in LGBT individuals compared with their heterosexual counterparts” (Lim et al., 2013,
p. 199).
education must be implemented into all nursing programs. Review of the nursing schools
One of the most effective ways to include educational material on this population would
be in the form a simulation labs. Scenarios should be developed by specially trained and highly
educated staff members with special interest related to LGBT. Topics should range from
transgender individuals to same sex partner issues. Also inclusion wording should be addressed
to not discriminate against this population. According to Lim et al. simulation is one of the
solutions for overcoming the limitations of traditional clinical education (Lim et al., 2013, p.
200). This article also suggests individuals designing simulation curricula should include LGBT
Another important way in to incorporate LGBT education into the nursing curriculum is
through the use of case studies. Case Studies “may be infused with LGBT identities and may ask
application-type questions that highlight best practices in cultural sensitivity”(Lim et al., 2013, p.
201). It is easy to adapt almost any case study question by simply asking the class “how would
you handle this situation if the patient was a member of LGBT community”?
Not only is important for nursing students to have adequate education related to this
population in order to properly care for the patients but it is “projected that approximately
150,000 to 300,000 nurses are LGBT” (Lim et al., 2013, p. 200). Not only will better education
for this population benefit the patient but it will also give you a better understanding of who you
References
Cupp Curley, A. L., & Vitale, P. A. (2012). Population-Based Nursing Concepts and
competenices for advanced Practice. New York, NY: Springer Publishing Company,
LLC.
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25
Lim, F. A., Brown, D. V., & Jones, H. (2013, April). Lesbian, gay, bisexual, and transgender
health: fundamentals for nursing education. Journal of Nursing Education, 52, 198-203.
http://dx.doi.org/10.3928/01484834-20130311-02