LGBTQIA+ Cultural Competence in Physical Therapy: An Exploratory Qualitative Study From the Clinician's Perspective

Area of Science:

• Health Professions Education
• Physical Therapy
• Health Equity

Background:

• Cultural competence is vital for addressing health disparities in diverse populations.
• Understanding the unique healthcare experiences of LGBTQIA+ individuals is essential for equitable care delivery.
• Physical therapists' perspectives on LGBTQIA+ cultural competence are underexplored.

Purpose of the Study:

• To explore the healthcare experiences of lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse (LGBTQIA+) individuals.
• To assess physical therapists' cultural competence in providing care to LGBTQIA+ patients.
• To identify barriers and facilitators to LGBTQIA+ cultural competence in physical therapy practice.

Main Methods:

• An exploratory qualitative study using semi-structured focus groups and interviews.
• Seventy-one practicing physical therapists in the USA participated.
• The Campinha-Bacote model of cultural competence guided the interview protocol.

Main Results:

• Key themes emerged across the Social Ecological Model: intrapersonal (stress, biases), interpersonal (acceptance, competency), organizational (experience), community (advocacy), and societal/policy (biases, policy).
• Psychological stress, limited awareness, decreased acceptance, and insufficient experience hinder LGBTQIA+ cultural competence.
• Lack of advocacy and broader societal/policy issues also present significant barriers.

Conclusions:

• Cultural competence in physical therapy is multifactorial, influenced by individual, interpersonal, organizational, and societal elements.
• Addressing identified barriers is critical to improving physical therapists' ability to provide affirming care to LGBTQIA+ patients.
• Further research is needed to incorporate student, educator, and patient perspectives to enhance LGBTQIA+ cultural competence in physical therapy.