Date of Graduation

Spring 5-21-2021

Document Type

Dissertation

Degree Name

Doctor of Psychology in Clinical Psychology (PsyD)

College/School

School of Nursing and Health Professions

Department

Psychology

Program

Clinical Psychology (PsyD)

First Advisor

Dr. David Martinez

Second Advisor

Dr. William Hua

Third Advisor

Dr. Erin Grinshteyn

Abstract

LGBTQ+ people's experiences of heterosexism, which are common in the healthcare system, are linked to poor health outcomes. There are no measures of LGBTQ+ people’s experiences in healthcare settings which could be used by healthcare systems and providers to improve the quality of their care for this vulnerable population. The Daily Heterosexist Experiences Questionnaire (DHEQ), developed using the minority stress model, measures the general stressful life experiences of LGBTQ+ people. This project aimed to adapt the DHEQ for use in healthcare settings.

A mixed-methods study was conducted to create the Daily Heterosexist Experiences Questionnaire-Healthcare (DHEQ-H). Semi-structured interviews focused on the healthcare experiences of LGBTQ+ patients were conducted with LGBTQ+ adults in the San Francisco Bay Area. This allowed for an initial adaptation of the DHEQ-H, which was distributed to a larger sample of LGBTQ+ participants. This data was then analyzed to assess the reliability and validity of the adapted measure.

The analysis revealed themes including discrimination/harassment, vigilance, isolation, vicarious trauma, disclosure-related stress, and having to educate providers as common experiences LGBTQ+ people face when accessing healthcare. Validity and reliability were established to create the Daily Heterosexist Experiences Questionnaire-Healthcare which measures these and other related themes. The DHEQ-H is the first tool of its kind that can be utilized by systems and providers to continue the task of improving healthcare experiences for the LGBTQ+ community, which could help to reduce identified health disparities in this population.

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