2 / 9
6
t h
I n t e r n a t i o n a l C o n f e r e n c e o n
Advance Nursing Practice
Journal of Nursing and Health Studies
ISSN 2574-2825
J u n e 2 1 - 2 2 , 2 0 1 8
P a r i s , F r a n c e
Advance Nursing Practice 2018
Page 20
L
esbian, gay, bisexual, and transgender (LGBT) individuals are designated by the
United States National Institutes of Health as a healthcare disparity population.
In general, LGBT people may experience increased disease prevalence,
premature or excessive mortality, increased burden of disease, and poorer daily
functioning. LGBT people may experience ‘minority stress,’ where chronic stress
due to stigmatization influences health and behavior through distal objective
stressors (actual experiences of violence and discrimination); proximal subjective
stressors (internalized homophobia) and perceived stigma (that one will be
rejected). Multiple factors may impact LGBT peoples’ ability to access healthcare
and maintain healthy living patterns. These may include: low socioeconomic
status / poverty, lack of health insurance or underinsured, poor living conditions,
homelessness or incarceration, risky health behaviors such as smoking, heavy
alcohol use, substance use, unprotected sex, HIV risk / STD risk, challenges with
psychological coping (e.g. depression, anxiety, suicidality), stigma of sexism,
racism, transphobia, homophobia etc. There are known cancer risks for the LGBT
community. Yet, the patient’s sexual orientation and gender identity (SOGI) are
often not known (or asked) during healthcare encounters. Cancer screening
rates are often low, and there are gaps in screening recommendations for LGBT
persons. Cancer prevention and early detection efforts are often lacking in this
community. Co-existing HIV adds to the risk of certain cancers and disease and
treatment outcomes. Advanced practice providers (APPs) can play key roles in
supporting care quality overall, and patient preventive care, screening uptake, and
care through the cancer continuum, in particular, through assessment, counseling,
education, advocacy, and intervention. As advanced practice providers, in multiple
settings (primary care, family care, acute care, oncology-specific care) become
expert in the culturally competent care of LGBT persons, they can contribute to the
improvement of quality of care and overall well-being of this health care disparity
population.
LGBT and cancer: improving quality of care
to lesbian, gay, bisexual, transgender
patients and their families with cancer
Robert David Rice
City of Hope National Medical Center, USA
Robert David Rice, J Nurs Health Stud 2018, Volume: 3
DOI: 10.21767/2574-2825-C3-007
Biography
Robert David Rice is the Director of Nursing Education, Evidence
Based Practice, and Research at City of Hope National Medical
Center in Duarte, CA. He joined City of Hope in July 2013. He
and his staff develop and apply cross-disciplinary education
programs to keep clinical providers current on evidence-
based best practices, clinical techniques, standards, and
emerging technologies unique to their clinical discipline.
His clinical and research interests include hematologic
malignancies, hematopoietic cell transplantation, cancer
chemotherapy / immunotherapy, immuno-oncology, psycho-
oncology, healthcare disparities, and improving the quality of
cancer care for LGBT patients and families. He participates
in national consortia of comprehensive cancer centers
which address quality initiatives, nurse sensitive indicators
(establishing a national benchmark for the incidence of vesicant
chemotherapy extravasation), and developing a core curriculum
to train nurses in safe chemotherapy administration.
drice@coh.org