Evidence map›Paper›PMID 28502218›Full record

ArticlePalliative medicine2018

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

Katherine Bristowe, Matthew Hodson, Bee Wee, Kathryn Almack, Katherine Johnson, Barbara A Daveson, Jonathan Koffman, Linda McEnhill, Richard Harding

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Palliative medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. A Systematic Review of Sexual Minority Women's Experiences of Health Care in the UK.International journal of environmental research and public health · 2019
    Pooled it
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. The 4Palliative & supportive care · 2025
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katherine Bristowe1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK.
Matthew Hodson2 GMFA, London, UK.
Bee Wee3 Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Kathryn Almack4 Nottingham Centre for the Advancement of Research into Supportive, Palliative and End-of-Life Care, The University of Nottingham, Nottingham, UK.
Katherine Johnson5 School of Applied Social Science, University of Brighton, Brighton, UK.
Barbara A Daveson1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK.
Jonathan Koffman1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK.
Linda McEnhill6 St. Joseph's Hospice, London, UK.
Richard Harding1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, UK.

Funding

Marie Curie MCCC-RP-14-A17159
6 · The paper itself

Abstract

backgroundLesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness.

aimTo explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples.

designSemi-structured in-depth qualitative interviews analysed using thematic analysis. SETTING/

participantsIn total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3).

resultsIn total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness.

conclusionDespite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

Indexed as

AdultAgedAged, 80 and overFemaleHealthcare DisparitiesHealth Services AccessibilityHumansMaleMiddle AgedQualitative ResearchSexual and Gender MinoritiesTerminally IllTransgender PersonsUnited KingdomYoung Adultadvanced illnessbereavementgender historyinequalitiesqualitativeSexual orientation

Identifiers

PMID28502218
PMCPMC5758934

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.