Knowledge and Practices of Palliative Care Providers: An Interpretive Description of Sexual and Gender Diverse Patient Care and Their Influences

Abstract

It is well documented that sexual and gender diverse (SGD) populations face discrimination in healthcare settings. Inquiry into this issue is important in all areas of healthcare, however palliative care is an excellent place to start this inquiry, as its underlying relational, person-centered, and holistic approaches theoretically offer a framework to support care delivery for SGD populations. This study explored care for SGD patients and families as described by multidisciplinary palliative care providers in community palliative care settings. Queer theory offered a lens for this study, supported by theorizations of relational inquiry and cultural safety. Interpretive description methodology with thematic analysis was applied to focus group data to generate three culminating themes: The effects of experience on care; “I’m scared I’m going to say the wrong thing”; and individually tailored approaches. The discussion speaks to the power of norms and how they affect ideas around provider discomfort and SGD disclosure. The discussion culminates with wondering how palliative care could be improved if some norms and structures of power are queered and reconceptualized. Recommendations from this research include increased and ongoing training that incorporates practice principles of cultural safety and relational inquiry, specifically understandings of power, safety, disclosure and provider discomfort. Additionally, policy makers and organizations are encouraged to engage with community SGD organizations, broaden their definitions of safety, and review if SOGI data collection can be done safely and effectively for SGD people.