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. 2025 Jan 29;25(1):144.
doi: 10.1186/s12909-025-06744-4.

Lesbian, gay, bisexual, and transgender clinical competence of health professionals in Poland and Spain: results of the health exclusion research in Europe (HERE) study

Piotr Karniej  1   2 , Anthony Dissen  3 , Łukasz Pietrzykowski  4 , Raúl Juárez-Vela  2 , Antonio Martinez Sabater  2   5   6 , Janina Kulińska  7 , Jakub Zieliński  8 , Michał Czapla  9   10   11
Affiliations

Lesbian, gay, bisexual, and transgender clinical competence of health professionals in Poland and Spain: results of the health exclusion research in Europe (HERE) study

Piotr Karniej et al. BMC Med Educ. .

Abstract

Introduction: Health disparities experienced by lesbian, gay, bisexual, and transgender (LGBT) individuals have been partially attributed to healthcare professionals' lack of cultural competence in addressing their specific needs. This study aimed to assess the differences in competencies and preparedness among health professionals from Poland and Spain when working with LGBT patients.

Methodology: Data were collected between June and August 2024 through a cross-sectional survey involving 673 health professionals (Mage = 33.54, SD = 9.74; 61.5% female), including 273 participants from Spain and 400 from Poland. Participants completed a self-administered survey, which included sociodemographic questions and the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS). Multivariate linear regression was used to analyze predictors of clinical preparedness, attitudes, and knowledge regarding LGBT care.

Clinical trial number: not applicable.

Results: Spanish health professionals showed higher total LGBT-DOCSS scores compared to Polish participants (B = 0.503, p < 0.001). Gender was a significant predictor, with men scoring higher in clinical preparedness (B = 0.771, p = 0.002), while women scored higher in attitudes (B = -0.457, p < 0.001). In Poland, age was positively correlated with clinical preparedness (B = 0.034, p = 0.022), and physicians scored significantly higher in overall competency compared to nurses/midwives (B = 0.621, p = 0.005). Participation in LGBT-related training was associated with higher clinical preparedness in both countries, with those attending training 3 or more times scoring higher than those who never attended (B = 1.659, p < 0.001).

Conclusion: The study revealed significant differences in LGBT competency between Polish and Spanish health professionals. Factors such as gender, age, profession, and participation in LGBT-related training were associated with these competencies. Results suggest that a more tailored approach in professional education and training may be necessary to ensure all health workers possess adequate skills and attitudes toward LGBT care.

Keywords: Clinical competence; Health Knowledge; LGBT; LGBT Health; Sexual and gender minorities.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted by the Declaration of Helsinki, and approved by the Bioethics Committee of Wrocław Medical University in Poland (Approval No. KB 976/2022) and the University of Valencia in Spain (Approval No. 2024-ENFPOD-3314668). This research is part of the Health Exclusion Research in Europe (HERE) project. Participation in the survey was entirely voluntary, with no collection of personal data, ensuring anonymity throughout. All potential participants were furnished with written information outlining the study’s purpose, objectives, procedures, and data protection measures. They were also allowed to reach out to the investigators with any questions at any point during the study. Informed consent was obtained from all participants before their involvement in the study. Clinical trial number: not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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