美国卫生系统中LGBTQ+包容性实践的实施决定因素:护士领导者的定性描述性研究
Hyunmin Yu1,2, April J Ancheta3,4, Dalmacio Dennis Flores3,2
1School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA hyuy@nursing.upenn.edu.
BMJ open
|November 6, 2025
概括
护士领导人确定了实施女同性恋,男同性恋,双性恋,跨性别者,酷尔或质疑以及其他性和性别多样性 (LGBTQ +) 包容性实践的促进者和障碍. 关键因素包括高管的参与,专门的资源,以及解决组织文化和社会政治气候.
科学领域:
- 医疗保健管理的管理
- 实施科学 实施科学
- 健康 公平 卫生 公平
背景情况:
- LGBTQ+个体面临着严重的健康差异.
- 实施包容性实践的努力正在进行中,但促进者尚未得到充分探索.
- 实施研究综合框架 (CFIR) 为理解实施提供了一个透镜.
研究的目的:
- 探索护士领导者对促进者和实施LGBTQ+包容性实践的障碍的观点.
- 确定可行的策略,以提高LGBTQ+在医疗保健环境中的包容性.
主要方法:
- 使用半结构面试进行定性描述性设计.
- 在CFIR框架的指导下进行采访.
- 专题分析了来自美国多个医疗保健系统的21名护士领导者的数据.
主要成果:
- 促进者包括LGBTQ+培训,EHR适应和高管参与.
- 确定了可采取行动的杆:专用服务,受保护的时间/预算,实施团队.
- 障碍包括反应性的组织文化和社会政治/法律气候.
- 当前调查中的测量差距阻碍了对LGBTQ+包容性的评估.
结论:
- 实施LGBTQ+包容性实践对于健康平等和社会正义至关重要.
- 了解多层次的实施环境至关重要.
- 未来的研究应该测试战略,开发包容性调查,并支持促进包容性的领导力.
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