Hospice interdisciplinary team providers’ attitudes toward sexual and gender minority patients and caregivers

• Published in: Patient education and counseling Vol. 103; no. 10; pp. 2185 - 2191
• Main Authors: Cloyes, Kristin G., Tay, Djin L., Iacob, Eli, Jones, Miranda, Reblin, Maija, Ellington, Lee
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2020
• Subjects: Attitude; Caregivers; End of life; Gender Identity; Hospice; Hospice Care; Hospice providers; Hospices; Humans; LGBT; Patient Care Team; Sexual and Gender Minorities; Sexual and gender minority; Sexual and gender minority; End of life; Hospice; Hospice providers; LGBT
• ISSN: 0738-3991; 1873-5134; 1873-5134
• DOI: 10.1016/j.pec.2020.07.004

•First study of hospice providers’ attitudes toward SGM patients and caregivers.•Hospice IDT providers had positive attitudes toward SGM patients and caregivers.•Being religious associated with more negative attitudes.•Higher education, longer time in hospice associated with more positive attitudes.•Education and training may enhance positive attitudes and improve communication. Hospice interdisciplinary team (IDT) providers’ attitudes toward sexual and gender minority (SGM) patients and family caregivers impacts quality of care and end-of-life outcomes. This study assessed hospice IDT provider attitudes toward SGM patients and caregivers and identified demographic predictors. Hospice IDT providers (N = 122) completed an adapted 11-item scale measuring attitudes toward SGM hospice patients and caregivers. Descriptive statistics, confirmatory factor analysis, and regression models were conducted. The hospice-adapted Attitudes Toward LGBT Patients Scale (ATLPS) demonstrated acceptable Cronbach’s alpha (0.707). Total scores ranged from 32 to 55 (M = 47.04, SD = 5.64) showing that attitudes were generally positive. Being religious (B=-3.169, p = 0.008) was associated with more negative attitudes, while higher education (B = 1.951, p = 0.002) and time employed in hospice agency (B = 0.600, p = 0.028) were associated with more positive attitudes. This is among the first studies to assess SGM-specific hospice IDT attitudes. Participants had relatively positive attitudes, influenced by religious beliefs, clinical experience, and education. CFA results suggest the need for better instruments to measure this complex construct. Education incorporating evidence of disparities, life-course perspectives, and end-of-life experiences of diverse cohorts of SGM patients and families may build on hospice IDT members’ experience and training by influencing attitudes, reducing bias and improving competency.