Date of Award

2019

Embargo Period

8-1-2024

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Teresa Kelechi

Second Advisor

Martina Mueller

Third Advisor

Chasity Walters Burrows

Abstract

Purpose: The purpose of this dissertation is to explore cancer-care disparities in sexual and gender minority (SGM) populations. A scoping review of the barriers to palliative cancer care, an integrative review of cancer screening among SGMs, a and an exploratory analysis of cancer screening data from the BRFSS dataset in SGM populations have been conducted. Problem/Aims: SGM populations are less likely to present for cancer screening, may present at later stages of the disease and be less likely to receive culturally sensitive palliative care. This dissertation aimed to provide evidence of these disparities by reviewing the literature, identifying disparities, and performing an exploratory analysis of the BRFSS dataset. Design including theoretical basis: Various versions of social ecological theoretical frameworks and queer theory were used for this dissertation. Arskey and O’Malley’s design was used to review the literature in the scoping review, Knafl and Whittmore’s strategy for the integrative review and an exploratory analysis using the BRFSSS’ cross sectional national dataset. Findings: Barriers to cancer screening and palliative care lead to healthcare disparities and exist on individual, organizational, and environmental levels. SGM barriers include fear of discrimination, social isolation, stigma, disenfranchised guilt, disproportionate advance care planning, distress, and poor coping. Organizational and environmental barriers include lack of healthcare provider education, poor visual representation of SGMs in health care environments, heterosexual assumptions, and overt discrimination. Conclusion: The findings from this dissertation identify and highlight SGM cancer care disparities. These data allow for targeted areas of targeted interventions and will further identify the need for routine collection of national health care data for SGM populations to reduce disparities.

Rights

All rights reserved. Copyright is held by the author.

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