April 9, 2010

Speaker examines keys to caring for diverse groups

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Peggy Chinn, Ph.D., R.N., speaks about cultural sensitivity at the School of Nursing. (photo by Anne Rayner)

Speaker examines keys to caring for diverse groups

Most health care providers need to do a better job of understanding and meeting the health needs of sexual and gender minorities, according to Peggy Chinn, Ph.D., R.N., who gave the keynote address for “Culture is More than Ethnicity: A Challenge for Healthcare Providers,” hosted by the Vanderbilt Schools of Nursing and Medicine last week.

Chinn, professor emerita at the University of Connecticut, founding editor of Advances in Nursing Science, and a national expert, provided an overview of the LGBTQI community (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning and Intersex) its subcultures and ways that health care providers can become more sensitive and responsive to this group.

For most people, disclosing their sexual orientation, or “coming out,” is a lifelong challenge that involves overcoming many societal stigmas. She also said that many members of the LGBTQI community often deal with additional stress — the added pressure of not easily fitting into a social or cultural structure.

“Ethnicity is visible, for instance, but someone who is LGBTQI can keep their identity invisible. But it adds stress; stress that never goes away,” said Chinn.

Those stigmas can result in health risks such as high rates of alcohol, tobacco and drug use, depression, anxiety and suicide; eating disorders and domestic violence. She also said that there are specific risks for disease among different subcultures, with evidence that suggests lesbians have a higher rate of breast cancer.

Chinn said each health care professional is responsible for learning about the populations for whom they provide care and to develop policies to address their needs and concerns. She recommends using the ASK (awareness, sensitivity, knowledge) model and provided a list of specific things health care providers can do to become more LGBTQI culturally sensitive.

She encouraged providers to “reflect on what it might be like to be an LGBTQI patient in your health care setting” and suggested talking with community members and inviting consumers to provide feedback.

She underscored the need to create a welcoming workplace with additional training and zero tolerance for sexual or gender identity harassment or discrimination. She encouraged providers to develop written policies and to take a closer look at legal issues, recognizing that many LGBTQI families are “chosen” rather than biological, and have different preferences for release of information and power of attorney.

“Anyone who has experienced any sense of marginalization identifies with the need to be a part of something bigger than themselves,” said Sarah Fogel, Ph.D., R.N., VUSN associate professor. “The message from this forum is that sexual and gender minorities belong within the health care culture, along with the many other cultures that enhance their daily lives.”

Chinn's address was followed by a panel discussion from Vanderbilt's Gay Straight Alliance members and a discussion of religion and spirituality in the LGBTQI culture led by Ellen Armour, Ph.D., M.A., and James Pace, D.S.N., M.Div.