Systematic review of educational interventions on older LGBT+ adults : recommendations for practice, education and research

Aim of the review: Research demonstrates that inequalities in outcomes on health and social wellbeing for LGBT+ older adults are perpetuated by a lack of inclusive services and cultural competence among the health and social care workforce. The aim of this review is to describe the educational interventions used to educate health and social care practitioners on the needs of older LGBT+ adults and the impact of such interventions on practitioners' knowledge, attitudes and competence. Search and review methodology: A systematic search of peer-reviewed papers published before February 2020 was conducted in the electronic databases MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC, Social Sciences Full Text and Web of Science. The search resulted in a screening of 2509 papers with 9 matching the inclusion criteria which were rated using the MERSQI quality measure. Findings: Positive outcomes were demonstrated across the studies, especially an increase in knowledge. Increases in skills and attitudes was less evident, especially in studies using shorter and less diverse intervention designs. Findings suggest that interventions that incorporate diverse teaching strategies, especially interactive experiential activities such as storytelling and inclusion of LGBT+ older adults, leads to higher engagement, increased awareness and empathy in participants. Conclusions and implications: Professional and vocational education is an important tool to improve cultural competency. Findings suggest that educators need to diversify intervention contents, approach LGBT+ education from an interdisciplinary perspective and involve LGBT people in the design, delivery and evaluation of education. This may have a positive impact on transfer of learning into practice and provide a more sustainable approach in addressing LGBT+ ageing inequalities in practice settings. Findings also suggest that researchers need to develop more robust study designs such as randomized controlled trials and focus on the longitudinal effects of educational interventions, which could improve the quality of study designs. Ethical approval: Ethical approval was not necessary

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review

Aim(s): To report review findings into interventions used to educate the health and social care workforce on the experiences and needs of LGBT+ older adults. Background: Research demonstrates that inequalities in outcomes on health and social well-being for LGBT+ older adults are perpetuated by the cumulative disadvantages from discrimination and social exclusion throughout the life course and a lack of culturally competent workforce. Methods: A systematic search of peer-reviewed papers published before February 2020 was conducted in electronic databases. The search resulted in a screening of 2,509 papers with nine matching the inclusion criteria, which were rated using the MERSQI quality measure. Results: Studies demonstrated some positive outcomes of interventions, especially an increase in knowledge, but less so in skills and attitudes. Discussion: More robust designs such as randomized controlled trials, the use of standardized measures and a focus more on the longitudinal impact of educational interventions could improve the quality of study designs. Conclusion(s): Diversification of intervention content and patient and public involvement in the design, delivery and evaluation of educational interventions could improve efforts and have a more sustained impact on LGBT+ ageing inequalities. Implications for Nursing Management: Nurse managers have important roles in supporting staff education and ensuring LGBT+ inclusive practice

"Teta, s kom si ti lezbijka?" : z izobraževanjem proti nevidnosti LGBT+ starih ljudi v socialni in zdravstveni oskrbi

The specific characteristics of life course and past experiences of LGBT+ old people require knowledge and awareness on the part of carers. In this paper, an international perspective to shed light on key issues in the field of inclusive care for LGBT+ older people is used, with a particular focus on the Slovenian context, drawing extensively on the findings of the European project “Being me” (2018–2020). In the project, we aimed to explore best practice in the area of education and to develop online learning materials and tools for social and health care workers. Among the principles and approaches that guided our research, the focus was put on intersectionality, resilience, strengths perspective, life stories, and collaboration with LGBT+ old people in all phases of the project

Learning to deliver LGBT+ aged care: exploring and documenting best practices in professional and vocational education through the World Café method

Substantial evidence on the adverse impact of ageing on lesbian, gay, bisexual and transgender (LGBT+) populations through the lack of inclusive care services has highlighted the need for education and training of the health and social care workforce to enhance their skills, knowledge and capabilities in this area. We describe a cross-national collaboration across four European Union countries called BEING ME. This collaboration examined the current pedagogic environment within professional, vocational and community-based education to identify what is most valuable for addressing these needs. The World Café method enabled a process of structured learning and knowledge exchange between stakeholders resulting in: (a) identification of best practices in pedagogies, (b) generation of tailored co-produced educational resources, and (c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT+ affirmative practices. Combined with themes from the post-Café evaluation, our findings suggest that underpinning professional and vocational education with a person-in-environment perspective facilitates going some way to acknowledging the historical context of older LGBT+ people's lives. Addressing the unique needs of sub-populations within LGBT+ communities and setting these in the context of holistic and person-centred care may better enable the meeting of their unique diverse needs for ageing. Recommendations are made for learning and teaching strategies to support improved LGBT+ aged care

Social Work Tales: Client as a “Talking Problem”

In social work context clients with their stories are strongly determined by their very “client” position, the core of which is a certain “social problem”. Written social work documents are often like a detailed list of user’s failures, mistakes, weak sides, deficiencies. The focus of writing is often on confirming whether a certain behaviour was appropriate or not. The author emphasises that written documents are not just dead words in the paper, but a sort of act, an intervention: they have real and actual power as professional opinions, reports, etc. This article includes recent findings in researching this matter in Slovene social work practice and suggests how to improve oral and writing professional practices toward more complex storytelling

The right to ‘have a say’ in the deinstitutionalisation of mental health in Slovenia

In a time when the deinstitutionalisation of mental health services has become a global and European platform and one of the main forms of care provision, a theme such as the transition of care from large institutions down to a more personal community level care might seem outlived, but the fact is that in some European countries the discussion has revolved for almost 35 years around the most basic question concerning the closure of large, asylum-type mental health institutions. In this article, I provide a historical overview and analysis of deinstitutionalisation processes in the field of mental health in Slovenia from mid-1980s onwards, interpreted in terms of achievements and gaps in community-based care and in user participation in these processes. It demonstrates some of the innovative participatory practices and their potential to transform services. A thematic data analysis was used to analyse the data collected from various primary (a focus group) and secondary sources (autobiographies, newspaper articles, round table reports, blogs) that all bear witness to the different periods of deinstitutionalisation and the user perspective in it

Lezbične in gejevske družine v Sloveniji: implikacije za socialno delo

Social science literature usually classifies lesbian and gay families among nontraditional, unconventional or alternative families. In the first part of the article the author draws attention to the inappropriate classification involved with such families. By using adjectives such as non-traditional, unconventional etc., we in fact emphasize the difference and deviation from normality that both automatically become the object of predomination. However, within such contexts "special" family forms become separated, inferior and unequal as proves the public discourse, which is infused with prejudice and the so-called concern of professional and laic public that discusses the consequences, children might endure growing up in such families. The author analyses the public institution\u27s discourse concerning lesbian and gay families by critically observing the main arguments introduced by different experts that the politics uses in order to contradict the legalisation of same-sex parenthood. Further on, the author examines the family support the children, mothers and fathers are given in such families, especially from the point of view of the social work. The author concludes that much potential and tasks are to be performed by social work in the context of contemporary changes in family life, especially in relation to lesbian and gay families.Lezbične in gejevske družine družboslovna literatura običajno uvršča med t.i. netradicionalne, nekonvencionalne ali alternativne družine. Avtorica v prvem delu članka opozarja na neprimernost takega klasificiranja družin. Z uporabo pridevnikov, kot so netradicionalno, nekonvencionalno ipd. v resnici poudarjamo razliko, odmik od normalnega, ki tako samodejno postane predmet prevlade. Posebne oblike družin pa znotraj takih kontekstov postanejo nekaj ločenega, inferiornega in neenakopravnega. To se vidi tudi v javnem govoru o teh družinah, ki je prežet s predsodki in še zlasti s skrbjo strokovnih in laične javnosti, kakšne posledice bi utegnilo imeti življenje v njih na otroke. V članku avtorica analizira govor javnih institucij do lezbičnih in gejevskih družin ter kritično pretrese poglavitne argumente različnih strok, ki se jih v političnem govoru uporablja proti legalizaciji istospolnega starševstva. V nadaljevanju pogleda, kakšne družinske podpore so deležni otroci, matere in očetje iz takih družin pri nas, še zlasti iz zornega kota socialnega dela. Ugotavlja, da ima socialno delo v kontekstu sodobnih procesov sprememb v družinskem življenju, in posebej pri delu z gejevskimi in lezbičnimi družinami veliko potencialov in nalog

The Right to 'Have a Say' in the Deinstitutionalisation of Mental Health in Slovenia

In a time when the deinstitutionalisation of mental health services has become a global and European platform and one of the main forms of care provision, a theme such as the transition of care from large institutions down to a more personal community level care might seem outlived, but the fact is that in some European countries the discussion has revolved for almost 35 years around the most basic question concerning the closure of large, asylum‐type mental health institutions. In this article, I provide a historical overview and analysis of deinstitutionalisation processes in the field of mental health in Slovenia from mid‐1980s onwards, interpreted in terms of achievements and gaps in community‐based care and in user participation in these processes. It demonstrates some of the innovative participatory practices and their potential to transform services. A thematic data analysis was used to analyse the data collected from various primary (a focus group) and secondary sources (autobiographies, newspaper articles, round table reports, blogs) that all bear witness to the different periods of deinstitutionalisation and the user perspective in it