Atención sanitaria trans* competente, situación actual y retos futuros. Revisión de la literatura
Resumo
Introducción: Conocemos como una persona trans* a aquella que no se identifica con el sexo de nacimiento, este hecho aún recogido como patología por el actual manual diagnóstico y estadístico de enfermedades mentales (DSM-V) va a provocar que existan desigualdades y barreras significativas a la hora de la atención sanitaria.
Objetivo: Explorar las dificultades para la asistencia sanitaria percibidas por las personas trans* y por los profesionales que los atienden en centros sanitarios.
Material y método: Revisión de la literatura.
Resultados: Tanto los profesionales como las personas trans* perciben barreras significativas. Se podrían agrupar en diversos temas: desigualdades en la atención sanitaria percibidas por los pacientes trans*, prejuicios y discriminación sentida, riesgos específicos de salud, déficit de conocimientos de los profesionales y déficit de formación en los planes de estudio actuales. Por otro lado, enfermería ante los pacientes trans* puede resultar un facilitador.
Conclusiones: Existen numerosos factores que pueden ser modificables y que provocan que las personas trans* no perciban una asistencia adecuada. La adecuada formación de los profesionales sanitarios es uno de los que adquiere mayor relevancia Los resultados encontrados aportan una información clave para el futuro diseño de intervenciones dirigidas a mejorar la calidad de la asistencia en este colectivo.
Downloads
Referências
Carabez R, & Scott M. “Nurses don”t deal with these issues’: nurses’ role in advance care planning for lesbian, gay, bisexual and transgender patients. J Clin Nurs. 2016;25(23–24):3707–15.
Suess A. Cuestionamiento de dinámicas de patologización y exclusión discursiva desde perspectivas trans e intersex. Rev Estud Soc. 2014;9(49):128–43.
Wagner PE, Kunkel A, Asbury MB, Soto F. Health (Trans) gressions: Identity and Stigma Management in Trans* Healthcare Support Seeking. Women Lang. 2016;39(1):49–74. 26p.
Thomas, R., Pega, F., Khosla, R., Verster, A., Hana, T., & Say L. Ensuring an inclusive global health agenda for transgender people. Bull World Heal Organ [Internet]. 2017;95(August 2016):154–6. Available from: http://dx.doi.org/10.2471/BLT.16.183913
Lim FA, Brown D V., Jones H. Lesbian, Gay, Bisexual, and Transgender Health: Fundamentals for Nursing Education. J Nurs Educ [Internet]. 2013;52(4):198–203. Available from: http://www.healio.com/doiresolver?doi=10.3928/01484834-20130311-02
Kosenko K, Rintamaki L, Raney S, Maness K. Transgender Patient Perceptions of Stigma in Health Care Contexts. Med Care [Internet]. 2013;51(9):819–22. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00005650-201309000-00010
Kroning, M., Green, J., & Kroning K. Dimensions of inclusive care. A young transgender patient sparks the need for an immediate education action plan. Nurs Manage. 2017;48(1):1.
Carabez R, Pellegrini M, Mankovitz A, Eliason M, Scott M. Does your organization use gender inclusive forms? Nurses’ confusion about trans* terminology. J Clin Nurs. 2015;24(21–22):3306–17.
Arenas Y, & Freitas M.G. El contexto social y la comprensión psicoterapéutica en la transexualidad. TRILOGÍA Ciencia, Tecnol y Soc. 2016;8:11–25.
Lindroth M. “Competent persons who can treat you with competence, as simple as that”- An interview study with transgender people on their experiences of meeting health care professionals. J Clin Nurs. 2016;25(23–24):3511–21.
Yingling CT, Cotler K, Hughes TL. Building nurses’ capacity to address health inequities: incorporating lesbian, gay, bisexual and transgender health content in a family nurse practitioner programme. J Clin Nurs. 2017;26(17–18):2807–17.
White Hughto JM, Reisner SL, Pachankis JE. Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med [Internet]. 2015;147:222–31. Available from: http://dx.doi.org/10.1016/j.socscimed.2015.11.010
Eyssel J, Koehler A, Dekker A, Sehner S, Nieder TO. Needs and concerns of transgender individuals regarding interdisciplinary transgender healthcare: A non-clinical online survey. PLoS One. 2017;12(8).
Sharek DB, Mccann E, Sheerin F, Glacken M, Higgins A. Older LGBT people’s experiences and concerns with healthcare professionals and services in Ireland. Int J Older People Nurs. 2015;10(3):230–40.
Alpert AB, CichoskiKelly EM, Fox AD. What Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Patients Say Doctors Should Know and Do: A Qualitative Study. J Homosex. 2017;64(10):1368–89.
Carabez, R. M., Eliason, M. J., & Martinson M. Nurses’ Knowledge About Transgender Patient Care: A Qualitative Study. Adv Nurs Sci [Internet]. 2016;39(3):257–71. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00012272-201607000-00007
Sallans RK. Lessons from a Transgender Patient for Health Care Professionals. AMA J ethics [Internet]. 2016;18(11):1139–46. Available from: http://journalofethics.ama-assn.org/2016/11/mnar1-1611.html%0Ahttp://www.ncbi.nlm.nih.gov/pubmed/27883306
Bockting, W. O., Knudson, G., & Goldberg JM. Counseling and Mental Health Care for Transgender Adults and Loved Ones. Int J Transgenderism. 2006;9(3–4):83–94.
Zunner BP, Grace PJ. The Ethical Nursing Care of Transgender Patients. AJN, Am J Nurs [Internet]. 2012;112(12):61–4. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00000446-201212000-00034
Costa AB, Pase PF, de Camargo ES, Guaranha C, Caetano AH, Kveller D, et al. Effectiveness of a multidimensional web-based intervention program to change Brazilian health practitioners’ attitudes toward the lesbian, gay, bisexual and transgender population. J Health Psychol [Internet]. 2016;21(3):356–68. Available from: http://journals.sagepub.com/doi/10.1177/1359105316628748
Fredriksen-Goldsen KI, Kim H-J, Shiu C, Goldsen J, Emlet CA. Successful Aging Among LGBT Older Adults: Physical and Mental Health-Related Quality of Life by Age Group. Gerontologist [Internet]. 2015;55(1):154–68. Available from: https://academic.oup.com/gerontologist/gerontologist/article/2957461/Successful
Bockting W, Robinson B, Benner A, Scheltema K. Patient satisfaction with transgender health services. J Sex Marital Ther. 2004;30(4):277–94.
Braun HM, Ramirez D, Zahner GJ, Gillis-Buck EM, Sheriff H, Ferrone M. The LGBTQI health forum: An innovative interprofessional initiative to support curriculum reform. Med Educ Online [Internet]. 2017;22(1). Available from: http://dx.doi.org/10.1080/10872981.2017.1306419
Chapman R, Watkins R, Zappia T, Nicol P, Shields L. Nursing and medical students’ attitude, knowledge and beliefs regarding lesbian, gay, bisexual and transgender parents seeking health care for their children. J Clin Nurs. 2012;21(7–8):938–45.
Neville S, Henrickson M. Perceptions of lesbian, gay and bisexual people of primary healthcare services. J Adv Nurs. 2006;55(4):407–15.
Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students’ ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med. 2006;38(1):21–7.
Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgenderism. 2012;13(4):165–232.
Hardacker CT, Rubinstein B, Hotton A, Houlberg M. Adding silver to the rainbow: The development of the nurses’ health education about LGBT elders (HEALE) cultural competency curriculum. J Nurs Manag. 2014;22(2):257–66.
Bosttock-Cox B. The role of primary care nurses in the care of transgender people. Pract Nurse. 2016;46(9):26–31.
Lim, F. A., & Hsu R. Nursing Students’ Attitudes Toward Lesbian, Gay, Bisexual, and Transgender Persons: An Integrative Review. Nurs Educ Perspect [Internet]. 2016;37(3):144–52. Available from: https://libproxy.singaporetech.edu.sg/login?url=http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=c8h&AN=115441563&site=eds-live
Chaet DH. The AMA Code of Medical Ethics’ Opinions Related to Discrimination and Disparities in Health Care. AMA J Ethics April. 2017;19(1):54–62.
Göçmen İ, Yılmaz V. Exploring Perceived Discrimination Among LGBT Individuals in Turkey in Education, Employment, and Health Care: Results of an Online Survey. J Homosex. 2017;64(8):1052–68.
Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., Head, E. M., & Bauer GR. “completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Serv Res. 2012;12(1).
Daley, A., & MacDonnell JA. “That would have been beneficial”: LGBTQ education for home-care service providers. Heal Soc Care Community. 2015;23(3):282–91.
As obras que são publicadas nesta revista estão sujeitas aos seguintes termos:
1. O Serviço de Publicações da Universidad de Murcia (a editorial) conserva os direitos patrimoniais (copyright) das obras publicadas, e favorece e permite a reutilização das mesmas sob a licença de utilização indicada no ponto 2.
© Serviço de publicações, Universidad de Murcia, 2011
2. As obras são publicadas na edição eletrónica da revista sob uma licença Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 Espanha (texto legal). Podem-se copiar, usar, difundir, transmitir e expor publicamente, sempre que: i) seja citado a autoria e a fonte original da sua publicação (revista, editorial e URL da obra); ii) não se usem para fins comerciais; iii) se mencione a existência e especificações desta licença de utilização.
3. Condições de auto-arquivo. É permitido e aconselha-se aos autores, difundir eletronicamente as versões pré-print (versão antes de ser avaliada) e/ou post-print (versão avaliada e aceite para a sua publicação) das suas obras antes da sua publicação, uma vez que, favorece a sua circulação e difusão mais cedo e com isso um possível aumento na sua citação e alcance entre a comunidade académica. Cor RoMEO: verde.