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Health Care Providers’ Knowledge, Attitudes, and Self-efficacy for Working With Patients With Spinal Cord Injury Who Have Diverse Sexual Orientations

A Burch, PT, EdD, MPH, is Associate Professor, Physical Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico

Address all correspondence to Dr Burch at: annleeburch{at}cprs.rcm.upr.edu

Background and Purpose: This study, using an evaluative, cross-sectional design, explored the self-efficacy, knowledge, and attitudes of health care providers who treat people with spinal cord injury (SCI) who may be gay, lesbian, bisexual, or transgender (GLBT). The study also designed and implemented a diversity training program and measured its effect on participants’ perceptions of their ability to change their knowledge levels, attitudes, and self-efficacy with regard to sexual orientation diversity.

Subjects and Methods: Health care professionals (N=402) participated in a diversity training program that included a pre-briefing questionnaire, a videotape, a post-briefing questionnaire, and discussion. Descriptive and chi-square analyses were performed on all variables of interest.

Results: The majority of the participants reported low levels of knowledge, attitudes of tolerance versus respect, and 0% to 20% confidence levels for providing culturally sensitive services for patients with diverse sexual orientations. Three hundred seventeen participants strongly agreed that watching the videotape increased their confidence levels in providing services for people who may be GLBT.

Discussion and Conclusion: Health care providers who treat people with SCI self-report low levels of knowledge, tolerance versus respect, and low levels of self-efficacy with regard to sexual orientation diversity. If a health care provider has a low level of knowledge, tolerance versus respect, and a low level of diversity self-efficacy toward others, there may be direct physical and mental health consequences for the patient. A limitation of the study was that social desirability bias may have increased the number of participants who reported increased levels of self-efficacy following the videotape. Further research is recommended (1) to determine whether current diversity training for health care professionals includes diversity of sexual orientation and (2) to examine the knowledge levels, attitudes, and self-efficacy of health care professionals with regard to sexual orientation diversity while attempting to control for social desirability bias in participants’ responses.

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