ACCESSCare C: Improving communication between clinicians & LGBT people
Research type
Research Study
Full title
ACCESSCare C: Improving communication between clinicians and LGBT (lesbian, gay, bisexual and/or trans) people with serious illness - a national qualitative study to develop and deliver evidence-based guidance
IRAS ID
232777
Contact name
Richard Harding
Contact email
Duration of Study in the UK
1 years, 5 months, 29 days
Research summary
Research Summary
BACKGROUND Lesbian, Gay, Bisexual and/or Trans (LGBT) people have worse health statuses, and poorer access to health services and health care experiences. Good communication and person-centred care that recognises sexual orientation and gender history/gender identity are essential to improve care. Poor communication can increase: NHS costs due to lack of engagement in care and crisis management, and the threat of not identifying significant others in situations of future lost capacity.\n\nAIMS\n1) To identify preferences of LGBT people with serious illness and caregivers, and examples of best practices from the perspectives of health care professionals and LGBT people, with respect to exploring and sharing information regarding sexual orientation and gender history/gender identity.\n2) To develop, field-test and deliver evidence-based freely accessible guidance and recommendations for use by clinicians and educators, to improve communication and information recording of sexual orientation and gender history/gender identity.\n\nDESIGN\nQualitative study with in-depth interviews, and resource development incorporating cognitive interviews.\nInterviews with up to 40 LGBT individuals and up to 20 informal caregivers of LGBT people recruited through referral from NHS services and national community routes. \nInterviews with up to 30 Multi-professionals (doctors, nurses, social workers) recruited from intensive care, respiratory, oncology, neurology, cardiology, renal, liver clinics and GPs from the London area. \n\nANALYSIS AND RESOURCE DEVELOPMENT\nInterviews will be analysed using thematic analysis. We will develop a resource for clinicians informed by the interview data. The target audience will be specialists dealing with serious illness, with relevance across all health and social care. By mapping the resource onto the findings from the interviews, we will ensure it represents patients’ and caregivers’ preferences, and reflects professionals’ expressed educational needs. Content will be refined by our Steering Group and community groups and cognitive interviews with n=5 clinicians.
Summary of Results
Lesbian, gay, bisexual and trans (LGBT+) people are at higher risk of some serious illnesses and worse healthcare experiences. Caring well for people with serious illnesses needs trusting relationships and an understanding of the patient as a whole person.
The way that professionals speak with LGBT+ patients, and people who are important to them, affects experiences of healthcare. However, professionals do not receive training on how to do this sensitively.
Researchers from the ACCESSCare-C project responded to this by aiming to identify how LGBT+ people with serious illness want their sexual orientation and gender identity or gender history to be engaged with by health and social care professionals.
They also aimed to develop freely accessible guidance on improving communication around sexual orientation and gender-related matters by clinicians and educators.
Researchers conducted interviews and findings from the interviews were used to develop draft guidance.
Seventy-four people were interviewed, including:
- 34 LGBT+ people with serious illness
- 13 informal caregivers including partners, friends, families
- 27 health and social care professionals working with people with serious illness.Three areas were identified in the interview data that describe ways to speak inclusively with LGBT+ people by:
1. Approaching all interactions using inclusive language 2. Being aware of self and surroundings 3. Creating inclusive opportunities for people to share aspects of self in care
Further interviews with 5 clinicians and involvement of patients and the public showed the guidance was well received and was considered useful.
Although LGBT+ people continue to have poor healthcare experiences, by exploring concerns of LGBT+ people with serious illness, their informal caregivers and professionals, the team produced free guidelines to enable professionals to use sensitive language with LGBT+ patients. The ACCESSCare-C team have shared findings at several conferences and will continue doing so with healthcare professionals and educators.
NOTE: This lay summary has been written with members of the public who have been involved in the research.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
18/LO/1254
Date of REC Opinion
21 Sep 2018
REC opinion
Further Information Favourable Opinion