Healthcare professionals hold positive attitudes towards LGBTQ+ young people in paediatric ED settings, but knowledge gaps exist

A new collaborative paper by researchers in Trinity College Dublin and colleagues in Children’s Health Ireland and University College Dublin – recently published in the leading journal Archives of Disease in Childhood(BMJ) – found that healthcare professionals held positive attitudes towards LGBTQ+ young people but were less confident in their knowledge of specific health issues.

They self-reported low levels of clinical preparedness.

The study set out to assess the competency of paediatric emergency department (PED) multidisciplinary staff in caring for LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, + inclusive of all identities) adolescents.

This is the first time competence in caring for LGBTQ+ patients has been assessed in Paediatric Emergency Medicine practitioners.

STUDY CONTEXT

• In 2019, a national report showed 13% of young people under the age of 23 identify as LGBTQ+.
• Three quarters of LGBTQ+ people feel that healthcare providers lack knowledge and sensitivity to LGBTQ+ issues with 20% seeking LGBTQ+ friendly clinicians because of bad experiences.
• LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, + inclusive of all identities) young people are a minority group that are at risk of healthcare inequality.
• Healthcare professionals from various backgrounds have reported a lack of formal training in caring for LGBTQ+ individuals.

The observational study required participants to complete the LGBT-Development of Clinical Skills Scale self-assessment tool of clinical competence.

The study was conducted across three PEDs and one urgent care centre pertaining to the Children’s Health Ireland healthcare group.

Eilísh Hardiman, Chief Executive Children’s Health Ireland, said:

“As the first report into competence in caring for LGBTQ+ patients in Paediatric Emergency Medicine, this research will play an important part in our on-going development of services for our LGBTQ+ patients in Children’s Health Ireland at Crumlin, Temple Street, Tallaght and Connolly Hospitals.

“Of particular note in the report is that patients are actively seeking LGBTQ+ friendly clinicians.

“Our Rainbow Badge initiative gives staff a way to show that Children’s Health Ireland offers open, non-judgmental and inclusive care for children, young people and their families who identify as LGBTQ+ and is one of the ways we aim to make a positive difference by promoting a message of inclusion.”

FINDINGS

• 71 eligible participants completed the study: 40 (56%) were doctors, and 31 (44%) were nurses.
• Attitudinal awareness: The mean score for attitudinal awareness was 6.54/7 (SD 0.59), indicating overall positive attitudes.
• Knowledge and skills: The mean score for knowledge was lower (5.34/7, SD 1.03) and lowest for clinical preparedness (3.39/7, SD 0.94).
• Participants were less confident in caring for transgender than LGB patients and scored very low when asked if they had received adequate training in caring for transgender young people (2.11/7)

Overall, the study demonstrates positive attitudes towards LGBTQ+ patients among PED staff. However, there was a gap in knowledge and clinical preparedness. Increased training in caring for LGBTQ+ young people is necessary.

Professor Agnes Higgins, a leading national expert on the health needs of LGBTQ+ people in Ireland, from the School of Nursing and Midwifery, Trinity College Dublin and lead advisor and support on this study, said:

“Health care practitioners who work from a position of inclusivity can make a significant impact on the lives of young LGBTQ+ who continue to face significant social stigmatization, discrimination, and marginalization.

“This study is an important first step in opening a national conversation about the education of paediatric emergency department (PED) staff in caring for LGBTQ+ young people”.

Dr Dani Hall, Consultant in Paediatric Emergency Medicine, CHI at Crumlin and Associate Clinical Professor, University College Dublin, and research lead on this study, said:

“It’s extremely encouraging to see such positive attitudes in our PED staff. However, the lack of formal education historically for healthcare professionals has led to a knowledge gap and lack of clinical preparedness, which in turn may lead to negative encounters with LGBTQ+ young people, despite our best intentions.

“We need formal training at both undergraduate and postgraduate levels to close this gap.

The results from this study have formed the baseline for research into the impact of different educational interventions in improving clinical skills.”

Link to paper: you can read full details on the study Staff competence in caring for LGBTQ+ patients in the paediatric emergency department at the following link: https://adc.bmj.com/content/early/2023/04/25/archdischild-2022-32