Family perceptions of quality of end of life in LGBTQ+ individuals: a comparative study

Background: Members of the lesbian, gay, bisexual, transgender, and queer community have encountered discrimination and stigmatization related to sexual orientation and/or gender identity both within healthcare establishments and in the larger community. Despite the literature describing inequities in healthcare, very little published research exists on the experiences of lesbian, gay, bisexual, transgender, and queer patients and family members in hospice care. Methods: A quantitative comparative descriptive design explored the difference in end-of-life experiences between a lesbian, gay, bisexual, transgender, and queer and non-lesbian, gay, bisexual, transgender, and queer cohort. One hundred and twenty-two family members of individuals who have died while under hospice care in the past 5 years completed the Quality of Dying and Death Version 3.2a Family Member/Friend After-Death Self-Administered Questionnaire. Results: Comparison of the experiences of the lesbian, gay, bisexual, transgender, and queer cohort ( n = 56) and non-LGBTQ cohort ( n = 66) yielded varying results, with the LGBTQ cohort experiencing lower quality end of life in some Quality of Dying and Death measures and no statistically significant difference from the non-LGBTQ cohort in others. Discussion: The findings from this study in combination with previously published works on lesbian, gay, bisexual, transgender, and queer health support the position that hospice providers must take concrete steps to ensure that professional caregivers and office staff are qualified to meet the needs of this marginalized population.

Queering Whole Person Care

This workshop is the product of a research study exploring the strategies that queer people develop to navigate hegemonic, heteropatriarchal health care systems, and ways that nurse education can incorporate a narrative-based, whole person care approach to understanding and supporting the needs of queer patients. This mixed-methods study included interviews with queer people, nurse educators and practicing nurses; textual analysis of queer health narratives; close reading of queer, feminist and cultural theory; and autoethnography.Some of the questions that we will explore are: How do queers use personal narratives to help navigate health care systems not designed to see/meet their needs? How do queers challenge dominant power structures in medicine? What does whole person care look like in a queer context? What would nurses like to see included in nursing education, and what do queers want health providers to know? What are the key pedagogical challenges in attempting such communication?The stories that queer people carry with them to medical encounters are a rich and underutilized resource for health care providers, and a tool for patients trying to manage serious or chronic illness. We will explore methods for including storytelling in nursing education as well as patient care, and participants will engage in a narrative medicine/autoethnographic exercise.We hope participants will leave our workshop with a better understanding of queer peoples' experiences of health care, and ways that queers and nurses can work together for better health outcomes.