Selected Articles
Collins, C. A. (2020). Pediatric nurse practitioners’ attitudes/beliefs and knowledge/perceived competence in caring for transgender and gender‐nonconforming youth. Journal for Specialists in Pediatric Nursing, 1-7. Web.
Lindsay, S., Kolne, K., & Rezai, M. (2020). Challenges with providing gender-sensitive care: Exploring experiences within pediatric rehabilitation hospital. Disability and Rehabilitation, 1–9. Web.
Qureshi, R., Zha, P., & Porter, S. (2020). An assessment of lesbian, gay, bisexual, and transgender health competencies among bachelors-prepared registered nurses in graduate-level study. Academic Medicine, 95(12), 113-120. Web.
Rider, G. N., McMorris, B. J., Gower, A. L., Coleman, E., Brown, C., & Eisenberg, M. E. (2019). Perspectives from nurses and physicians on training needs and comfort working with transgender and gender-diverse youth. Journal of Pediatric Health Care, 33(4), 379-385. Web.
Traister, T. (2020). Improving LGBTQ cultural competence of RNs through education. The Journal of Continuing Education in Nursing, 51(8), 359-366. Web.
Quantitative Study Analysis
Collins, C. A. (2020). Pediatric nurse practitioners’ attitudes/beliefs and knowledge/perceived competence in caring for transgender and gender‐nonconforming youth. Journal for Specialists in Pediatric Nursing, 1-7. Web.
The purpose of this study was “to determine pediatric nurse practitioners (PNP) attitudes/beliefs and knowledge/ competence in caring for TGNC youth” (Collins, 2020, p. 1). The study design selected was non-experimental. Additionally, the study is a cross-sectional descriptive study with a sample of 93 participants (pediatric nurse practitioners [PNPs]). The sample used in this study was selected through non-probability sampling.
The researcher used a convenience sample of PNPs drawn from eight states in the US. The researcher first contacted the State Boards of Nursing from the involved states and requested them to provide a list of all registered PNPs through the respective states together with their email listings. The states that were in a position to provide the required information were chosen and included in the sample, which makes it non-probability sampling because PNPs from states that could not give the needed data stood no chance of being involved in the study.
Approval from the relevant Institutional Review Board (IRB) was obtained after which the researcher proceeded to send emails to the potential participants. The emails introduced the study and provided a link for the participants to complete an online survey. Before starting the survey, the participants were required to sign a consent form through the online platform. The researcher then sent reminders two weeks after forwarding the original email. A total of 910 emails were sent but only 121 participants responded of which 93 were selected for final participation after cleaning the data through inclusion-exclusion criteria. Data on the participants’ responses were collected and recorded using Qualtrics online survey software. Two research questions were used
- What are the attitudes/ beliefs and knowledge/perceived competence of PNPs related to caring for TGNC youth?
- Is there an association between attitudes/beliefs and knowledge/perceived competence of PNPs and their age, number of years in advanced practice, whether or not they have cared for trans patients, and whether or not they have received continuing education related to TGNC youth? (Collins, 2020, p. 2).
Two instruments for data collection were used in this study. The first one is the transgender attitudes and beliefs scale (TABS), which is “a 29‐item survey which aims to determine the attitudes and beliefs about people who are transgender” (Collins, 2020, p. 3). Some of the questions included in TABS were, “I would be comfortable working for a company that welcomes transgender individuals” and “Whether a person is male or female depends upon whether they feel male or female” (Collins, 2020, p. 3). The second instrument was developed by the author and named it transgender competence and knowledge survey (TraCKS).
This instrument’s objective is to assess the level of knowledge and perceived competence among participants when taking care of transgender children. The face validity of TraCKS was ascertained using pilot testing involving 10 PNPs. Based on the results from the pilot testing and feedback from experts, some minor changes were made to make the final 14-item, 7-point-Likert scale. According to Collins (2020), some of the questions included in this instrument were “I am familiar with the term gender dysphoria,” and “I am familiar with the treatments for gender dysphoria or transgender transition” (p. 3). Even though this was a quantitative study, one qualitative question was included allowing the participants to indicate any thoughts they had concerning caring for transgender youth.
The collected data were analyzed using SPSS Statistics Version 25. Demographic data, such as years of practice, age, state of practice, and gender of the participating PNPs were analyzed descriptively. Mean scores for the tools used in data collection were tabulated to answer the first research question while different statistical tests were applied to answer the second research question. Finally, the qualitative question was analyzed to identify recurring themes among the participants’ responses and the percentages of these themed responses were calculated.
The participants’ ages ranged from 26 years to 74 years and 97 percent were female. The number of years of experience ranged between 1 and 42 years and 81 percent of the participants indicated that they had at least cared for one patient identified as transgender and gender‐nonconforming (TGNC). 85 percent of the participants said that their advanced practice education prepared them adequately to care for TGNC. However, 65 percent of the PNPs indicated that they had been involved in continuing education that mainly focused on TGNC care over the previous 5 years. The results showed that those involved in continuing education on caring for TGNC perceived themselves as more competent as compared to their counterparts who were not involved in such a form of learning. Additionally, there was no significant correlation between perceived competency in caring for TGNCs and the age, gender, and years of experience among the PNPs.
The qualitative question raised three themes. First, the participants emphasized that the lack of education negatively affected their competency when dealing with PNPs. Second, they noted that such patients need to be referred to appropriate gender services where they would get comprehensive services. Third, they noted that transgender patients needed to be supported together with their families.
This study clearly showed that lack of education affects PNPs’ competency when dealing with TGNC children and adolescents. This information is of concern because the available data showed that over 81 percent of the participants had attended to at least one patient identified as TGNC. Despite such high numbers of TGNC cases, only 15 percent of the participants indicated that they had received any form of training on dealing with transgender patients during their advanced nursing practice education. The participants who had taken part in continuing education on caring for TGNC patients perceived themselves as competent.
These findings indicate that the development of sensitivity training and education of nurses would ensure comprehensive care and support for transgender and gender-diverse children and adolescents. Additionally, such training would provide the needed knowledge for nurses to change their attitudes toward TGNC pediatric patients, which is a way of improving their cultural competence to address healthcare disparities experienced by this group of patients.
The analysis of this cross-sectional descriptive study has shown that training and education significantly affect nurses’ attitudes, beliefs, and perceived competence when dealing with TGNC patients. Therefore, nurses should get involved in continuing education to improve their knowledge on this subject. Various resources on this topic are available online; for instance, the World Professional Association for Transgender Health (WPATH) has evidence-based information based on standards of care for such patients. Additionally, the National LGBT Health Education Center has learning modules for professionals and other useful information for anyone interested in caring for TGNC patients.
Finally, it is important to incorporate transgender-related content in nursing curricula to ensure that nurses are readily prepared to care for TGNC patients. The content in this article addresses the PICOT question comprehensively.
Reference
Collins, C. A. (2020). Pediatric nurse practitioners’ attitudes/beliefs and knowledge/perceived competence in caring for transgender and gender‐nonconforming youth. Journal for Specialists in Pediatric Nursing, 1-7. Web.