Background: Transgender and gender nonbinary (trans/NB) individuals face many barriers to accessing health care in the United States due to systemic and clinician discrimination. Such experiences can lead to avoidance or delays in seeking care. These issues are relevant for emergency department (ED) clinicians and staff because trans/NB patients may use the ED in times of crisis.
Objectives: The purpose of this study was to qualitatively explore experiences of trans/NB individuals accessing health care in the ED and provide recommendations for improvements.
Methods: This study involved semi-structured qualitative interviews with nine trans/NB individuals living in Arkansas about their experiences when visiting local EDs.
Results: Interviews revealed four main themes: 1) system and structural issues; 2) interactions with clinicians/staff influence care received; 3) perceptions of clinician knowledge and education about trans/NB health; and 4) impact on future health and health care access. Participants recommended education for current and future ED clinicians and staff to improve knowledge of best practices for trans/NB health care. Recommendations were also made to improve ED policy for inclusive and affirming intake processes, intake forms, and electronic health record (EHR) documentation, including documentation and use of patients' chosen name and pronouns.
Conclusion: The negative experiences and discrimination reported by trans/NB patients in ED visits underscores the importance of improving ED clinician knowledge of gender-affirming care practices, ED intake policies and practices, and EHR documentation in EDs.
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http://dx.doi.org/10.1016/j.jemermed.2021.04.013 | DOI Listing |
JMIR Form Res
January 2025
Minneapolis VA Health Care System, Minneapolis, MN, United States.
Background: The increasing use of ChatGPT in clinical practice and medical education necessitates the evaluation of its reliability, particularly in geriatrics.
Objective: This study aimed to evaluate ChatGPT's trustworthiness in geriatrics through 3 distinct approaches: evaluating ChatGPT's geriatrics attitude, knowledge, and clinical application with 2 vignettes of geriatric syndromes (polypharmacy and falls).
Methods: We used the validated University of California, Los Angeles, geriatrics attitude and knowledge instruments to evaluate ChatGPT's geriatrics attitude and knowledge and compare its performance with that of medical students, residents, and geriatrics fellows from reported results in the literature.
Background And Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe subtype, metabolic dysfunction-associated steatohepatitis (MASH), are highly prevalent and strongly associated with obesity and type 2 diabetes (T2D). This study sought to identify challenges to the diagnosis, treatment and management of people living with MASLD and MASH and understand the key barriers to adopting relevant clinical guidelines.
Methods: A real-world, cross-sectional study (BARRIERS-MASLD) consisting of a quantitative survey and qualitative interviews of physicians in France, Germany, Italy, Spain and the United Kingdom was conducted from March to September 2023.
JMIR Ment Health
January 2025
Division of Psychiatry, University College London, London, United Kingdom.
Background: Digital interventions typically involve using smartphones or PCs to access online or downloadable self-help and may offer a more accessible and convenient option than face-to-face interventions for some people with mild to moderate eating disorders. They have been shown to substantially reduce eating disorder symptoms, but treatment dropout rates are higher than for face-to-face interventions. We need to understand user experiences and preferences for digital interventions to support the design and development of user-centered digital interventions that are engaging and meet users' needs.
View Article and Find Full Text PDFJMIR Pediatr Parent
January 2025
General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: Mental health problems among adolescents are increasing, and internet-delivered acceptance and commitment therapy (iACT) constitutes a possible way to improve access to care while reducing costs. Nevertheless, few studies have investigated iACT for adolescents in regular primary care nor the role of parental support.
Objective: This is an exploratory evaluation investigating iACT, with or without parental support, for adolescents.
J Med Internet Res
January 2025
Centre for Addiction and Mental Health, Toronto, ON, Canada.
Background: The onset of the COVID-19 pandemic precipitated a rapid shift to virtual care in health care settings, inclusive of mental health care. Understanding clients' perspectives on virtual mental health care quality will be critical to informing future policies and practices.
Objective: This study aimed to outline the process of redesigning and validating the Virtual Client Experience Survey (VCES), which can be used to evaluate client and family experiences of virtual care, specifically virtual mental health and addiction care.
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