Self-Efficacy of Undergraduate Nursing Students in Providing Culturally Competent End-of-Life Care to LGBTQ+ Patients

Abstract

Nurses represent the largest group of health care professionals in the United States and spend more time with patients at the end-of-life (EOL) than any other health care professionals. Often, the quality of EOL nursing care is less than adequate in meeting the diverse cultural needs of lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) patients and their families, particularly regarding sensitivity to the unique challenges of this diverse population. Furthermore, culturally competent educational content for EOL care as it relates to LGBTQ+ patients is often lacking in nursing curricula. The purpose of this study was to assess baccalaureate nursing students’ self-efficacy for providing EOL care to LGBTQ+ patients. Additionally, this study sought any association between the level of religiosity of baccalaureate nursing students in an urban, faith-based private college and their self-efficacy to offer culturally competent EOL care in the context of LGBTQ+ patients. The theory of self-efficacy was used to guide this study. The sample consisted of 56 undergraduate BSN nursing students divided into a control group (n = 16) and an intervention group (n = 40). It was established that both the control and intervention groups were the same at baseline. This study used a combined instrument: the Palliative Care Self-Efficacy Scale (PCSES) to measure self-efficacy to care for patients at EOL, and four questions from the Gay Affirmative Practice (GAP) Scale to assess the cultural competence regarding LGBTQ+ patients. The intervention was an online educational intervention specifically aimed at familiarizing students with LGBTQ+ issues. Although no significant change was seen following the online educational training, associations were found between the level of religiosity and the pre-intervention GAP scores for both groups and between the level of religiosity and the post-intervention GAP scores for the intervention group. More religious students were found to be more sensitive to the EOL needs of LGBTQ+ patients.