Journal List > Korean J Women Health Nurs > v.25(4) > 1139377

Kang and Min: Effects of LGBT Nursing Education Using Simulation

Abstract

Purpose

As health care needs for Lesbian, Gay, Bisexual and Transgender (LGBT) are becoming increasingly important, it has become imperative for the nurses to be attentive towards their health problems and provide nursing care with an open-minded attitude. Due to limited opportunity to provide direct nursing care to LGBT patients, it is hypothesized that simulation would provide good opportunity for students to experience LGBT nursing care in a safe environment. This study was conducted to develop and apply simulation of LGBT nursing care to ultimately provide unbiased nursing care for LGBT population and prepare basic data for LGBT nursing education.

Methods

This study was a single-group pre-post experimental design study for 57 senior nursing students based on the comparison of existing LGBT knowledge, general attitude towards LGBT, and nursing attitude towards LGBT before and after simulation. The scenario content included discussion of coming out issue, providing sexual health information, and supportive nursing care for LGBT population. Data were analyzed with descriptive statistics and Wilcoxon signed rank.

Results

Simulation education-led to a significant increase in LGBT knowledge and nursing attitude. However, there was no change in the general attitude towards LGBT.

Conclusion

The results of this study suggest that LGBT education using simulation may be effective for nursing students and nurses from the point of concern for LGBT population. It is hypothesized that future LGBT educational programs might need more detailed information from both care recipients and nurses. Finally, LGBT education needs to be included in the nursing education curriculum.

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Figure 1.
Development process of LGBT nursing education program. LGBT=Lesbian, Gay, Bisexual and Transgender.
kjwhn-25-379f1.tif
Table 1.
General Characteristics of Participants (N=57)
Characteristics Categories n(%) M±SD
Age (year) 22.5±1.05
Religiosity Yes 26 (45.6)
No 31 (54.3)
Experience on LGBT education Yes 23 (40.3)
No 34 (59.6)
Delivery of methods of LGBT education Lecture 18 (78.3)
Discussion 5 (21.7)

LGBT=Lesbian, Gay, Bisexual and Transgender; M±SD=mean±standard deviation.

Table 2.
Knowledge toward LGBT (N=57)
Items Correct answer Pre-test correct rate Post-test correct rate Post-test rank
n(%) n(%)
Q3. Homosexual men always act and dress in a feminine way. F 56 (98.2) 55 (96.5) 1
Q5. Homosexuals may experience some or all of the six phases of “coming out.” T 29 (50.9) 55 (96.5) 1
Q7. Bisexuals will eventually “come out” as homosexuals. F 56 (98.2) 55 (96.5) 1
Q12. Homosexual women always dress and act in a masculine way. F 55 (96.5) 55 (96.5) 1
Q15. LGBT patients may present with signs of depression due to lack of social acceptance. T 56 (98.2) 54 (94.7) 5
Q10. Transgender women (male to female) are always attracted to people with male genitals. F 48 (84.2) 53 (93.0) 6
Q1. Sex and gender have the same meaning. F 52 (91.2) 52 (91.2) 7
Q8. Bisexual behavior is often just a cry for attention. F 53 (93.0) 51 (89.5) 8
Q13. LGBT patients do not seek medical treatment as early as heterosexuals because of fear of discrimination. T 49 (86.0) 49 (86.0) 9
Q14. Most health care providers automatically make the assumption that their patient is heterosexual if they have not specifically addressed sexual orientation. T 47 (82.5) 49 (86.0) 9
Q11. A transgender person should be addressed using pronouns of the preferred gender rather than biological sex. T 48 (84.2) 48 (84.2) 11
Q6. It is important to conduct a suicide assessment when working with LGBT patients. T 49 (86.0) 47 (82.5) 12
Q9. In order to be considered transgender, a person must have undergone a sexual reassignment surgery. F 33 (57.9) 43 (75.4) 13
Q2. Most homosexuals want to be members of the opposite sex. F 40 (70.2) 41 (71.9) 14
Q4. Homosexual men are more likely to be victims of violent crime than the general public. T 11 (19.3) 14 (24.6) 15

LGBT=Lesbian, Gay, Bisexual and Transgender; T=true; F=false.

Table 3.
Comparison of ATLG, ATLGBTP between Pre-test and Post-test (N=57)
Scale Items Pre-test Post-test
M±SD M±SD
ATLG Lesbian just can’t fit into our society. 1.57±0.87 1.42±0.84
A woman’s homosexuality should not be a cause for job discrimination in any situation. 1.25±0.57 1.28±0.72
Female homosexuality is detrimental to society because it breaks down the natural divisions between the sexes. 1.65±0.99 1.63±1.08
State laws regulating private, consenting lesbian behavior should be loosened. 1.67±0.95 1.73±1.06
Female homosexuality is a sin. 1.63±1.19 1.61±1.13
The growing number of lesbians indicates a decline in American morals. 1.58±1.08 1.56±0.96
Female homosexuality in itself is no problem, but what society makes of it can be a problem. 1.82±1.16 1.84±0.96
Female homosexuality is a threat to many of our basic social institutions. 1.89±1.17 1.86±1.18
Female homosexuality is an inferior from of sexuality. 1.40±0.86 1.47±0.94
Lesbians are sick. 1.30±0.73 1.39±0.79
Male homosexual couples should be allowed to adopt children the same as hetero-sexual couples. 2.18±1.18 2.21±1.29
I think male homosexuals are disgusting. 1.70±0.94 1.67±1.02
Male homosexuality should not be allowed to teach school. 1.49±0.78 1.56±0.90
Male homosexuality is a perversion. 1.35±0.71 1.35±0.81
Just as in other species, male homosexuality is natural expression of sexuality in human men. 1.89±1.08 1.91±1.13
If a man has homosexual feelings, he should do everything he can to overcome them. 1.77±0.94 1.77±1.05
I would not be too upset if I learned that my son were a homosexual. 3.16±1.29 3.04±1.13
Homosexual behavior between two men is just plain wrong. 1.37±0.74 1.49±0.92
The idea of male homosexual marriages seems ridiculous to me. 1.46±0.73 1.46±0.73
Male homosexuality is merely a different kind of lifestyle that should not be condemned. 1.58±0.96 1.49±0.80
Total 1.68±0.66 1.68±0.68
ATLGBTP I would prefer not to provide nursing care for LGBT patients. 4.70±0.82 4.75±0.54
I would refuse to care for an LGBT patient if I were aware they identify as LGBT. 4.80±0.63 4.56±0.96
I feel competent to provide nursing care for LGBT patients. 4.74±0.72 4.72±0.55
LGBT patients do not have any specific health needs. 4.00±1.11 4.05±1.12
I feel I would be able to talk with a patient who identifies as LGBT in a sensitive and appropriate manner. 3.63±0.87 3.98±0.81
Total 3.97±0.40 4.06±0.41

ATLG=Attitude towards Lesbians and Gay Men; ATLGBTP=Attitudes toward Lesbian, Gay, Bisexual and Transgender Patients; LGBT=Lesbian, Gay, Bisexual and Transgender; M±SD=mean±standard deviation.

Reverse item.

Table 4.
Comparison of Dependent Variables between Pre-test and Post-test (N=57)
Items Pre-test Post-test Z p
M±SD Median (Q1–Q3; IQR) M±SD Median (Q1–Q3; IQR)
Knowledge toward LGBT 11.96±1.76 12.00 (11.00–13.00; 2.00) 12.65±1.94 13.00 (11.00–14.00; 3.00) −3.02 .003
ATLG 1.68±0.66 3 1.35 (1.20–2.15; 0.95) 1.68±0.68 1.40 (1.15–2.17; 1.02) −0.76 .448
ATLGBTP 3.97±0.40 4.00 (3.83–4.16; 0.33) 4.06±0.41 4.16 (3.83–4.30; 0.47) −2.18 .030

LGBT=Lesbian, Gay, Bisexual and Transgender; ATLG=Attitude towards Lesbians and Gay Men; ATLGBTP= Attitudes toward Lesbian, Gay, Bisexual and Transgender Patients; Q1=first quartile; Q3=third quartile; IQR=interquartile range; M±SD=mean±standard deviation.

Table 5.
Satisfaction of LGBT Simulation Education
Items M±SD Rank
I was able to ask any questions at any time during the education. 4.23±0.90 1
I am satisfied with the content of the education. 4.11±0.70 2
I did not have any inconvenience during the education period as there were sufficient instructions and explanations for the procedures before entering education. 4.09±0.80 3
I got a satisfactory answer from the instructor about the questions I had during the education. 4.07±0.84 4
I am satisfied with the way the course was conducted. 4.00±0.80 5
I think the method of performance evaluation was fair. 3.95±0.85 6
The amount I had to study during the education was adequate. 3.82±0.85 7
I gained a lot of satisfaction through education. 3.82±0.73 8
I was able to reach and maintain the learning level (objectives) through education. 3.72±0.77 9
During the education, I received enough feedback and comments to make sure I was doing well. 3.54±1.00 10
Total 3.93±0.58

M±SD=mean±standard deviation; LGBT=Lesbian, Gay, Bisexual and Transgender.

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