LGBT Content in Health Assessment Textbooks

A new study evaluated nursing textbooks for LGBT inclusivity and found very little relevant content, especially content that demonstrated deeper understanding of LGBT health concerns.

The study, published in the Journal of Professional Nursing, used The Process of Cultural Competence in the Delivery of Healthcare Services as a framework to perform a content analysis on two nursing textbooks. This framework lists five constructs that the authors used to assess the textbooks’ LGBT competence: cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire.

Most of the constructs appeared in at least one of the textbooks, with the exception of cultural desire (which was interpreted as providing external resources to learn more about LGBT health). Even so, the authors found that the textbooks lacked content with deeper understanding or explanation of the LGBT population’s needs. They note that it may be difficult for a textbook to provide a truly comprehensive account of LGBT health needs, but the textbooks do not make an effort to direct students to external resources either. Both books do address provider bias, intersections of patient identities/multiple marginalization, and history taking for LGBT patients, but they also place too much emphasis on concerns about STIs without devoting equal time to other well-documented health concerns in the LGBT community.

The authors conclude that more research is needed to truly understand how increased LGBT content in textbooks might affect providers, but they note the importance of textbook content in guiding discussions and promoting inclusivity. Students benefit from inclusive content and become better providers when they are more fully able to understand their patients.

The authors of the study provide several resources for professional development, including the Fenway Institute’s Understanding the Health Needs of LGBT People, the AAMC’s Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who are LGBT, Gender Nonconforming, or Born with DSD, and case studies provided by the AIDS Education and Training Center–National Multicultural Center. Additionally, offerings like QSPACES’ LGBTQ+ competency training and consulting services can help healthcare providers and members of other organizations improve their cultural competence in areas that aren’t thoroughly addressed in textbooks or training.

You can access the full text of the study in the Journal of Professional Nursing here: http://www.professionalnursing.org/article/S8755-7223(17)30364-2/fulltext

You can access The Process of Cultural Competence in the Delivery of Healthcare Services here: http://journals.sagepub.com/doi/pdf/10.1177/10459602013003003

You can access the Fenway Institute’s Understanding the Health Needs of LGBT People here: http://www.lgbthealtheducation.org/wp-content/uploads/LGBTHealthDisparitiesMar2016.pdf

You can access the AAMC’s Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who are LGBT, Gender Nonconforming, or Born with DSD here: https://members.aamc.org/eweb/upload/Executive%20LGBT%20FINAL.pdf

You can access the case studies provided by the AIDS Education and Training Center–National Multicultural Center here: https://aidsetc.org/resource/case-studies-lesbian-gay-bisexual-and-transgender-lgbt-persons

You can learn more about QSPACES’ LGBTQ+ competency training and consulting services here: https://www.qspaces.org/lgbtq-training/