Proud Stories Project: LGBTIQ+ patients’ satisfaction after a narrative medicine intervention at their primary care centres: community intervention study

Abstract

Background Sexual orientation and gender identity, have remained invisible in healthcare services, and studies researching LGBTIQ+ health indicate that the discrimination and stigma felt by this community, are affecting their health. On the daily basis, professionals do not know how to behave and what to say to their LGBTIQ+ patients as they were never trained for it. Satisfaction is never used as an objective way to understand those inequalities, even though it is a valid method. Narrative medicine, a new model for empathy, reflection, and trust regarding patient-health care professionals, uses close reading and reflective writing to improve this relationship and enhance all the humane parts of it. Objective The aim of this study is to assess LGBTIQ+ patients’ satisfaction after a narrative medicine intervention on primary care professionals (nurses, doctors, TCAI (“tècnics en cures auxiliars d’infermeria”) and administrative staff), in comparison to their satisfaction previous to the intervention, and in comparison to not doing it (control group). As secondary objectives, we pretend to determine the overall satisfaction, discrimination perception and the frequentation of LGBTIQ+ patients in their Primary Care Centre (PCC). Study Design This study has been designed as a community intervention study. Study population LGBTIQ+ patients over 18 years old, who used public health services in the last 10 years and are part of the 12 centres participating in the study. They must agree to participate in it. Methods Among all the centres in the Health Region of Girona, 6 centres will be chosen as the exposed group and 6 will be the control group. 372 of these centres’ LGBTIQ+ patients will be the sample, and since it is a hidden population, we will combine the snowball method and volunteering as sampling methods. On the exposed group, a narrative medicine session with some patients will be done to collect written experiences on accessing health as LGBTIQ+, and then a session with the exposed centres’ professionals will include a read-through of those texts and a debate on how they felt and how they would change these situations. A validated survey that assesses patient satisfaction, frequentation, and perception of discrimination will be applied to both exposed and control groups at the baseline and 6 months after the intervention. Results will be assessed through a mix model controlling the covariates