Journal of Nursing Education

Research Briefs 

Assessing Undergraduate Nursing Students’ Knowledge, Attitudes, and Cultural Competence in Caring for Lesbian, Gay, Bisexual, and Transgender Patients

Kristy L. Strong, BSN, RN; Victoria N. Folse, PhD, APN, PMHCNS-BC, LCPC

Abstract

Lesbian, gay, bisexual, and transgender (LGBT) patients experience barriers to health care that include fear of discrimination, as well as insensitivity and lack of knowledge about LGBT-specific health needs among providers. This study examined the effectiveness of an educational intervention designed to improve knowledge and attitudes of baccalaureate nursing students regarding LGBT patient care. Education focused on key terminology, health disparities, medical needs of transgender patients, and culturally sensitive communication skills for competent LGBT patient care. Knowledge level and attitudes were evaluated before and after the intervention using a survey based on a modified Attitudes Toward Lesbians and Gay Men Scale and two assessment tools developed for this study. A statistically significant increase in positive attitudes and knowledge level was found immediately after the intervention. Findings from this study support the inclusion of education related to LGBT patient health care in undergraduate nursing curricula to promote cultural competence and sensitivity. [J Nurs Educ. 2015;54(1):45–49.]

Ms. Strong is a Registered Nurse, Cardiovascular Intensive Care Unit, Carle Foundation Hospital, Urbana; and Dr. Folse is Director and Professor, School of Nursing, Illinois Wesleyan University, Bloomington, Illinois. At the time this article was written, Ms. Strong was a student, Illinois Wesleyan University, Bloomington, Illinois.

The authors have disclosed no potential conflicts of interest, flnancial or otherwise.

Address correspondence to Victoria N. Folse, PhD, APN, PMHCNS-BC, LCPC, Director and Professor, School of Nursing, Illinois Wesleyan University, P.O. Box 2900, Bloomington, IL 61701; e-mail: vfolse@iwu.edu.

Received: May 07, 2014
Accepted: September 13, 2014
Posted Online: December 24, 2014

Abstract

Lesbian, gay, bisexual, and transgender (LGBT) patients experience barriers to health care that include fear of discrimination, as well as insensitivity and lack of knowledge about LGBT-specific health needs among providers. This study examined the effectiveness of an educational intervention designed to improve knowledge and attitudes of baccalaureate nursing students regarding LGBT patient care. Education focused on key terminology, health disparities, medical needs of transgender patients, and culturally sensitive communication skills for competent LGBT patient care. Knowledge level and attitudes were evaluated before and after the intervention using a survey based on a modified Attitudes Toward Lesbians and Gay Men Scale and two assessment tools developed for this study. A statistically significant increase in positive attitudes and knowledge level was found immediately after the intervention. Findings from this study support the inclusion of education related to LGBT patient health care in undergraduate nursing curricula to promote cultural competence and sensitivity. [J Nurs Educ. 2015;54(1):45–49.]

Ms. Strong is a Registered Nurse, Cardiovascular Intensive Care Unit, Carle Foundation Hospital, Urbana; and Dr. Folse is Director and Professor, School of Nursing, Illinois Wesleyan University, Bloomington, Illinois. At the time this article was written, Ms. Strong was a student, Illinois Wesleyan University, Bloomington, Illinois.

The authors have disclosed no potential conflicts of interest, flnancial or otherwise.

Address correspondence to Victoria N. Folse, PhD, APN, PMHCNS-BC, LCPC, Director and Professor, School of Nursing, Illinois Wesleyan University, P.O. Box 2900, Bloomington, IL 61701; e-mail: vfolse@iwu.edu.

Received: May 07, 2014
Accepted: September 13, 2014
Posted Online: December 24, 2014

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience barriers to health care in the United States that cause health disparities. Discrimination against LGBT patients and provider ignorance of LGBT-specific health care needs further exacerbate this issue. The profession of nursing must increase efforts to ensure a culturally competent and knowledgeable nursing workforce while eliminating health disparities and improving patient outcomes in vulnerable populations, including the LGBT community.

Barriers to Health Care for LGBT Patients

Several issues discourage LGBT patients from seeking health care, including concerns about negative attitudes and lack of knowledge among health care providers, as well as personal experiences associated with “minority stress.” Brooks (1981) defined minority stress as the stress experienced by individuals from stigmatized social categories as a result of inferior social status. Minority stress has been linked to LGBT health disparities, including substance abuse, tobacco use, and mental health disorders (Bolton & Sareen, 2011; Grant et al., 2010; Gruskin, Greenwood, Matevia, Pollack, & Bye, 2007; Lehavot & Simoni, 2011).

Studies report low levels of knowledge related to LGBT patients, as well as negative attitudes among nurses and nursing students toward LGBT patients (Chapman, Watkins, Zappia, Nicol, & Shields, 2012; Eliason, DeJoseph, Dibble, Deevey, & Chinn, 2011; Eliason, Donelan, & Randall, 1992; Röndahl, 2009; Röndahl, Innala, & Carlsson, 2004). Lack of knowledgeable health care providers has been identified as one of the top barriers to culturally sensitive health care for the LBGT patient population (Grant et al., 2010; Sanchez, Sanchez, & Danoff, 2009). Negative attitudes and lack of competent providers may deter LGBT patients from seeking health care (Samuel & Zaritsky, 2008).

The Profession of Nursing and the LGBT Community

Nursing Research

Nursing research has inadequately addressed the health needs of the LGBT population. Between 2005 and 2009, the top 10 nursing journals published only eight articles focused on LGBT health issues of almost 5,000 total articles (Eliason, Dibble, & DeJoseph, 2010). Many studies exclude bisexuals and transgender people and focus on gays and lesbians only (Eliason et al., 2010; Shields et al., 2012). A previous study demonstrated improvement in knowledge regarding LGBT patient care after an educational intervention among medical students (Kelley, Chou, Dibble, & Robertson, 2008), but a study focusing on nursing students has not been published.

A Nursing Curriculum for the Future

The Gay and Lesbian Medical Association (2010) and Healthy People 2020 identified LGBT cultural competence training as an integral part of all medical and nursing school curricula and continuing education for those already in the workforce (U.S. Department of Health and Human Services, 2013). The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 2008) calls for undergraduate nursing curricula to prepare the graduate to meet the needs of vulnerable populations and eliminate health disparities. Recommendations have been made regarding key content in undergraduate nursing curricula to provide a strong foundation for cultural competence with LGBT patients (Brennan, Barnsteiner, Siantz, Cotter, & Everett, 2012; Jeffreys & Dogan, 2012).

Purpose

The purpose of the current study was to address the educational needs suggested by the literature and determine whether undergraduate nursing majors’ knowledge, attitudes, and cultural competence toward LGBT patients could be improved.

Research Questions

The following questions guided this study:

  • What is the degree of reliability of the modified Attitudes Toward Lesbians and Gay Men (ATLG) Scale, the newly developed Lesbian, Gay, Bisexual, and Transgender Healthcare (LGBT Healthcare) Scale, and the newly developed Lesbian, Gay, Bisexual and Transgender Knowledge (LGBT Knowledge) Questionnaire?
  • How effective is a LGBT educational intervention as measured by differences between preintervention and postintervention knowledge and attitudes?

Method

Participants

A convenience sample of 88 nursing students at an undergraduate university in the midwestern United States agreed to participate. Complete responses from 58 students were included in the data analysis; partial sets of responses were excluded from analysis. Eligibility requirements included age of 18 years or older and a declared nursing major.

Instruments

Attitudes Toward Lesbians and Gay Men (ATLG) Scale. The modified ATLG Scale was used to assess the attitudes of the participants regarding the LGBT patient population. Permission to use and modify the ATLG Scale for this study was obtained; recommendations from the authors included use of the three-item version of the ATLG Scale and a 5-point Likert scale for scoring. The ATLG Scale was expanded by the current research team to include items specific to bisexual and transgender individuals in a format similar to the original ATLG Scale (e.g., “I think bisexuals are disgusting”). The original ATLG Scale has been found to be reliable, with a Cronbach’s alpha >0.85 with college student samples (Herek & McLemore, 2011).

Lesbian, Gay, Bisexual, and Transgender Healthcare (LGBT Healthcare) Scale. The LGBT Healthcare Scale is a 6-item Likert scale that allows for an opportunity for written elaboration by participants. The first three items were based on questions asked of health care professionals in an earlier study conducted by Harris, Nightengale, and Owens (1995). The remaining three items (perceptions of competence, cultural sensitivity skills, and nursing curricula) were developed by the current research team and were specific to an undergraduate nursing student population.

Lesbian, Gay, Bisexual, and Transgender Knowledge (LGBT Knowledge) Questionnaire. The LGBT Knowledge Questionnaire is a 15-item true or false questionnaire. Two items (Q2, Q4) were taken from the Knowledge About Homosexuality Questionnaire developed by Harris et al. (1995), and 13 items were developed by the current research team after a review of the literature.

Procedure

Following institutional review board approval, participants were recruited in collaboration with four professors during scheduled class time. The study was described, written informed consent was obtained, and a packet containing the pretests and posttests was distributed to possible participants. The informed consent documents were detached from the demographics sheets and pretests to preserve confidentiality of the participants. Gender was intentionally excluded from the demographic survey due to the small number of male nursing students. All pretest and posttest materials were coded with a letter representing the student’s year in school and a number so that data collection materials could be matched for analysis. No academic or monetary incentives were offered for participation in the research study, and no consequences existed for refusal to participate.

The educational intervention was developed based on content recommended by Brennan et al. (2012) and was organized as PowerPoint® slides. To promote content validity, the intervention was piloted with an expert panel consisting of seven members of the university’s Pride Alliance, a registered student organization for those who identify as part of the LGBT community or an ally. The Pride Alliance members provided feedback about the relevance and delivery of the content, and select changes were then made to the educational intervention by the research team. This resulted in a 40- to 45-minute educational intervention that focused on relevant definitions, LGBT health disparities, cultural competence, and transgender-specific health care. One hour was allotted for the educational intervention and posttest. Nursing students studying abroad participated through the use of Polycom® technology so that they could synchronously see and hear the lecture.

Results

Demographics

Results were analyzed using IBM SPSS® Statistics for Windows, version 21.0. The sample contained four first-year students (6.9%), six second-year students (10.3%), 20 third-year students (34.5%), and 28 fourth-year students (48.3%). All students in the sample self-identified as heterosexual; two students had identified as homosexual, but their incomplete data were not included in analysis. Forty-eight (82.8%) of the students indicated that they identify with a religion. Twenty-two students (37.9%) identified as Democrats, 18 (31%) as Republicans, 16 (27.6%) indicated no political affiliation, one student (1.7%) did not respond, and one student (1.7%) marked “other” but did not elaborate.

Students were asked if they personally knew anyone who identified as a part of the LGBT community. Forty-six students reported they had a friend (79.3%), 32 reported they knew an acquaintance (55.2%), and 14 students reported they had a family member (24.1%) who identified as a part of the LGBT community. Students were queried about the most influential factors influencing their attitudes about the LGBT community; fifty-two students confirmed that the attitudes of family or friends (89.7%) were most influential, 33 reported positive or negative experience with the LGBT community (56.9%), and 16 indicated that the attitudes of the media (27.6%) were most influential. Two students wrote in religion (3.4%), although this option was not listed on the demographic sheet.

Reliability

Internal Consistency. The degree of reliability of the modified ATLG Scale was measured through internal consistency. Internal consistency was evaluated through Cronbach’s alpha and a high degree of reliability was established (α = 0.95). The degree of reliability of the LGBT Healthcare Scale was also evaluated through Cronbach’s alpha, and a suboptimal level of reliability was established in this sample (α = 0.54).

The degree of reliability of the LGBT Knowledge Questionnaire was measured through the alpha coefficient Kuder-Richardson 20 (KR-20). The LGBT Knowledge Questionnaire had a suboptimal level of reliability (α = 0.54). Analysis of reliability was reevaluated after separating the nursing-specific items (Q6, Q13, Q14, and Q15) from items that were LGBT-specific knowledge (Q1–5 and Q7–12). However, removal of the general nursing knowledge items did not improve the reliability (α = 0.52). Deletion of low-performing items identified through item–total correlations was not theoretically supported and was not pursued.

Criterion-Related Validity

Paired Sample t Tests. A paired sample t test was used to determine whether the differences between pretest and posttest responses were attributed to chance alone. The mean results of the modified ATLG Scale increased from pretest to posttest, indicating an increase in positive attitudes. Differences in mean scores of the lesbian, bisexual, and transgender subscales were statistically significant (Table 1).

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Attitudes Toward Lesbians and Gay Men (ATLG) Scale

Table 1:

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Attitudes Toward Lesbians and Gay Men (ATLG) Scale

The mean scores of the LGBT Healthcare Scale increased from pretest to post-test, with one exception seen in the item regarding refusal to care for an LGBT patient (Table 2). Higher scores on the LGBT Healthcare Scale indicated more positive attitudes. Two items (Q3 and Q4) on the LGBT Healthcare Scale had statistically significant differences between pretest and posttest scores. Narrative responses from students indicated a variety of new knowledge gained and validated the need for more emphasis in the nursing curriculum to focus on LGBT-specific health care.

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Lesbian, Gay, Bisexual, and Transgender (LGBT) Healthcare Scale

Table 2:

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Lesbian, Gay, Bisexual, and Transgender (LGBT) Healthcare Scale

A statistically significant increase in LGBT Knowledge Questionnaire scores (Table 3) was noted when comparing the total pretest score (M = 13.48, SD = 1.490) and posttest score (M = 14.67, SD = 0.758) of all 15 items (t[57] = 6.554, p < 0.0001). Five of 15 items (Q1, Q4, Q5, Q6, and Q13) were statistically significant between pretest and posttest (Table 4).

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Mean Scores of Total Correct of 15 Items

Table 3:

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Mean Scores of Total Correct of 15 Items

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Significant Individual Items

Table 4:

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Significant Individual Items

Frequencies were used to determine which questions were missed most often on the pretest and posttest LGBT Knowledge Questionnaire. The three most frequently missed pretest questions were Q1, “sex and gender have the same meaning” (79.3% correct); Q4, “homosexual men are more likely to be victims of violent crime than the general public” (77.6% correct); and Q6, “it is important to conduct a suicide assessment when working with LGBT patients” (75.9% correct). Only one of 15 pretest items was answered correctly by all participants, whereas five of 15 items in the posttest were answered correctly by all participants. The top two most frequently missed posttest items were Q4 (91.4% correct) and Q6 (94.8% correct).

Discussion

Changes in attitudes toward lesbians, bisexuals, and transgender individuals were significantly improved after the intervention. Eliason et al. (2010) found that transgender people were the least researched and therefore were expected to have the lowest mean score on the modified ATLG Scale. However, results of this study indicated bisexuality was met with the most negative attitudes in this sample.

Knowledge was improved as seen through the statistically significant increase in the mean scores of the LGBT Knowledge Questionnaire after a 40- to 45-minute lecture. These findings are consistent with the study conducted by Kelley et al. (2008), in which the authors included a 2-hour educational session with a patient panel and case studies. The brief educational intervention used in this study demonstrated the potential to have a favorable impact on students’ knowledge and attitudes. Undergraduate nursing students indicated the current nursing curriculum inadequately addressed LGBT patient care, as shown in the low score of Q6 regarding the nursing curriculum on the LGBT Healthcare Scale. This finding supports future incorporation of content regarding LGBT patient care into undergraduate nursing curricula.

Limitations

No established tools were found that met the current study’s needs; therefore, the LGBT Healthcare Scale and LGBT Knowledge Questionnaire were developed by the research team. Reliability for both tools was suboptimal, which may have been influenced by the small number of items in each instrument. Revision of the tools must be considered before use in subsequent studies.

Three of the four educational interventions were conducted during scheduled class time, which was intended to encourage participation, but it also limited the amount of content that could be included. Timing of recruitment and barriers related to data collection may have impacted sample size. Students studying abroad viewed the educational intervention through the use of Polycom technology; the complicated logistics of returning materials may have been a deterrent to completing all study materials.

The convenience sample recruited has limited generalizability to undergraduate nursing students due to only one school of nursing being used for recruitment and the high degree of homogeneity among participants. This study was cross-sectional, so whether changes in attitudes and knowledge were retained or whether future nursing care will be improved after the intervention should be evaluated in a longitudinal study.

Conclusion

Nursing students in previous studies have identified a need for improved knowledge and cultural competence regarding LGBT patients (Chapman et al., 2012). The current study demonstrated that a brief educational intervention has the power to improve attitudes and strengthen the knowledge level regarding LGBT patient care. On the basis of this pilot study, undergraduate schools of nursing should incorporate content about the LGBT patient population into the curriculum to promote a competent nursing workforce and to improve LGBT patient care.

References

  • American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
  • Bolton, S. & Sareen, J. (2011). Sexual orientation and its relation to mental disorders and suicide attempts: Findings from a nationally representative sample. The Canadian Journal of Psychiatry, 56, 35–43.
  • Brennan, A.M., Barnsteiner, J., Siantz, M.L., Cotter, V.T. & Everett, J. (2012). Lesbian, gay, bisexual, transgendered, or intersexed content for nursing curricula. Journal of Professional Nursing, 28, 96–104. doi:10.1016/j.profnurs.2011.11.004 [CrossRef]
  • Brooks, V.R. (1981). Minority stress and lesbian women. Lexington, MA: Lexington Books.
  • Chapman, R., Watkins, R., Zappia, T., Nicol, P. & Shields, L. (2012). Nursing and medical students’ attitude, knowledge and beliefs regarding lesbian, gay, bisexual and transgender parents seeking health care for their children. Journal of Clinical Nursing, 21, 938–945. doi:10.1111/j.1365-2702.2011.03892.x [CrossRef]
  • Eliason, M., DeJoseph, J., Dibble, S., Deevey, S. & Chinn, P. (2011). Lesbian, gay, bisexual, transgender, and queer/questioning nurses’ experiences in the workplace. Journal of Professional Nursing27(4), 237–244. doi:10.1016/j.profnurs.2011.03.003 [CrossRef]
  • Eliason, M., Donelan, C. & Randall, C. (1992). Lesbian stereotypes. Health Care for Women International, 13, 131–144. doi:10.1080/07399339209515986 [CrossRef]
  • Eliason, M.J., Dibble, S. & DeJoseph, J. (2010). Nursing’s silence on lesbian, gay, bisexual, and transgender issues: The need for emancipatory efforts. Advances in Nursing Science, 33, 206–218. doi:10.1097/ANS.0b013e3181e63e49 [CrossRef]
  • Gay and Lesbian Medical Association. (2010). Healthy people 2010: A companion document for lesbian, gay, bisexual, and transgender (LGBT) health. Retrieved from http://www.med.umich.edu/diversity/pdffiles/healthpeople.pdf
  • Grant, J.M., Mottet, L.A., Tanis, J., Herman, J.L, Harrison, J. & Keisling, M. (2010). National transgender discrimination survey report on health and healthcare. Retrieved from http://transequality.org/PDFs/NTDSReportonHealth_final.pdf
  • Gruskin, E.P., Greenwood, G.L., Matevia, M., Pollack, L. & Bye, L. (2007). Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California. American Journal of Public Health, 97, 1496–1502. doi:10.2105/AJPH.2006.090258 [CrossRef]
  • Harris, M., Nightengale, J. & Owens, N. (1995). Health care professionals’ experience, knowledge, and attitudes concerning homosexuality. Journal of Gay and Lesbian Social Services, 2, 91–107. doi:10.1300/J041v02n02_06 [CrossRef]
  • Herek, G. & McLemore, K. (2011). The attitudes toward lesbians and gay men (ATGL) scale. In Fisher, T., Davis, C., Yarber, W. & Davis, S. (Eds.), Handbook of sexuality-related measures (3rd ed., pp. 415–417). Oxford, England: Taylor & Francis.
  • Jeffreys, M.R. & Dogan, E. (2012). Evaluating the influence of cultural competence education on students’ transcultural self-efficacy perceptions. Journal of Transcultural Nursing, 23, 188–197. doi:10.1177/1043659611423836 [CrossRef]
  • Kelley, L., Chou, C.L., Dibble, S.L. & Robertson, P.A. (2008). A critical intervention in lesbian, gay, bisexual, and transgender health: Knowledge and attitude outcomes among second-year medical students. Teaching & Learning in Medicine, 20, 248–253. doi:10.1080/10401330802199567 [CrossRef]
  • Lehavot, K. & Simoni, J. (2011). The impact of minority stress on mental health and substance use among sexual minority women. Journal of Consulting and Clinical Psychology, 79, 159–170. doi:10.1037/a0022839 [CrossRef]
  • Röndahl, G. (2009). Students’ inadequate knowledge about lesbian, gay, bisexual, and transgender persons. International Journal of Nursing Education Scholarship, 6, 1–15. doi:10.2202/1548-923X.1718 [CrossRef]
  • Röndahl, G., Innala, S. & Carlsson, M. (2004). Nursing staff and nursing students’ emotions towards homosexual patients and their wish to refrain from nursing, if the option existed. Scandinavian Journal of Caring Sciences, 18, 19–26. doi:10.1111/j.1471-6712.2004.00263.x [CrossRef]
  • Samuel, L. & Zaritsky, E. (2008). Communicating effectively with transgender patients. American Family Physician, 78, 648–650.
  • Sanchez, N.F., Sanchez, J.P. & Danoff, A. (2009). Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City. American Journal of Public Health, 99, 713–719. doi:10.2105/AJPH.2007.132035 [CrossRef]
  • Shields, L., Zappia, T., Blackwood, D., Watkins, R., Wardrop, J. & Chapman, R. (2012). Lesbian, gay, bisexual, and transgender parents seeking health care for their children: A systematic review of the literature. Worldviews on Evidence-Based Nursing, 9, 200–209. doi:10.1111/j.1741-6787.2012.00251.x [CrossRef]
  • U.S. Department of Health and Human Services. (2013). 2020 topics and objectives. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Attitudes Toward Lesbians and Gay Men (ATLG) Scale

SubscaleTotal Score (Pretest)SDTotal Score (Posttest)SDMean DifferencetSignificance (2-Tailed)
Gay11.692.63112.072.3080.3791.8730.066
Lesbian11.342.90511.972.4560.6212.5780.013*
Bisexual10.812.67211.782.2870.9663.498< 0.001*
Transgender11.452.24912.292.0350.8454.203< 0.001*

t Test Results and Mean Pretest–Posttest Scores of Participants (n = 58) on the Lesbian, Gay, Bisexual, and Transgender (LGBT) Healthcare Scale

QuestionMean PretestSDMean PosttestSDtSignificance (2-Tailed)
Q1: I would prefer not to provide nursing care for LGBT patients.4.410.6764.530.5691.6290.109
Q2: I would refuse to care for an LGBT patient if I were aware that they identify as LGBT.4.790.4094.760.432−0.5740.568
Q3: I feel competent to provide nursing care for LGBT patients.3.521.9063.880.1103.0240.004*
Q4: LGBT patients do not have any specific health needs.3.840.7454.410.5935.035< 0.001*
Q5: I feel I would be able to talk with a patient who identifies as LGBT in a sensitive and appropriate manner.4.170.7724.170.7751.3830.172
Q6: I believe the nursing curriculum adequately addresses the LGBT population.2.210.7962.350.8761.2110.231

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Mean Scores of Total Correct of 15 Items

Mean Score/15 (Pretest)Mean Score/15 (Posttest)tSignificance (2-Tailed)
13.4814.676.699< 0.001*

Participant (n = 58) t Test Results of Lesbian, Gay, Bisexual, and Transgender (LGBT) Knowledge Questionnaire: Significant Individual Items

QuestiontSignificance (2-Tailed)
Q1: Sex and gender have the same meaning.3.856< 0.001*
Q4: Homosexual men are more likely to be victims of violent crime than the general public.2.0550.044*
Q5: Homosexuals may experience some or all of the six phases of “coming out.”2.4300.018*
Q6: It is important to conduct a suicide assessment when working with LGBT patients.3.0350.004*
Q13: LGBT patients do not seek medical treatment as early as heterosexuals because of fear of discrimination.2.4030.020*

10.3928/01484834-20141224-07

Sign up to receive

Journal E-contents