Magnet hospitals: Investigating administrative opportunities to provide and improve lesbian, gay, bisexual, and transgender healthcare

Research studies support a significant amount of homonegativity in the nursing profession. There is a dearth of LGBT specific literature from nursing academics and clinicians whereby LGBT related concerns and issues remain consistently overlooked by the profession. Perhaps in no greater way is this reticence illustrated than in the Magnet Status Recognition Program, a program developed and awarded by the American Nurses Credentialing Center. This study sought to understand relationships among factors that might influence, describe and predict Directors of Nursing's (DONs) cues-to-action in advocating for Lesbian, Gay, Bisexual and Transgender (LGBT) employees and patients. In addition this study sought to describe what influence attitudes and beliefs toward LGBT individuals might have on DONs self-efficacy in providing inclusive policies for LGBT communities. To understand these relationships more clearly, the Health Belief Model (HBM) was employed as the guiding framework for this study. According to the HBM, low self-efficacy was associated with impedance toward adopting health-related actions. Modifying factors like attitudes and beliefs and demographic characteristics were theorized as influencing ones perceived self-efficacy. This study investigated the effect of DONs demographic information on attitudes and beliefs toward LGBT individuals. Further, demographic effects on self-efficacy and cues-to-action in LGBT related advocacy were explored. A sample of 334 DONs from Magnet designated hospitals was surveyed about their attitudes and beliefs about LGBT individuals. Data were collected using a validated instrument previously used to measure attitudes toward LGBT individuals. Self-efficacy was determined using a score from four items total, with two reflecting personal self-efficacy and two reflecting professional self-efficacy.;DONs with more positive attitudes toward LGBT individuals scored higher in perceived personal self-efficacy (r = .333, p = .001) and professional self-efficacy (r = .481, p = .000). Demographics that most frequently predicted given cues-to-action included descriptive location, region and religiosity. The HBM demonstrated utility as an explanatory framework to examine DONs executive practice in advocating for LGBT patients and employees. Further research is needed to examine health related issues in LGBT communities and to determine nursing's responsibilities in policy development particularly as it relates to LGBT equity in healthcare.