Facilitating lesbian gay bisexual transgendered and intersexed youth-inclusive primary health care in Tshwane district Gauteng province South Africa : a constructivist grounded theory study

Abstract

Introduction: Youth is a time when young people start to explore and discover their sexuality and sexual orientation and begin to identify themselves as either heterosexual or LGBTI. Most of those who identify as LGBTI are prone to a range of abuse, discrimination and victimisation; as well as health care inequalities. As a result, they experience poorer physical and mental health outcomes than the general population. The aim of the study was to develop a substantive theory focused on the basic social processes involved in facilitating LGBTI youth-inclusive PHC in Tshwane District, Gauteng Province, SA. The objectives included to explore and describe the experiences of LGBTI youth regarding health care they received in PHC clinics, to describe the experiences of nurses regarding caring for LGBTI youth in PHC clinics; and to explore and describe the basic social processes involved in facilitating LGBTI youth-inclusive PHC. A constructivist grounded theory was used. Interviews were held with an initial sample of seven LGBTI youth and five registered nurses working in PHC followed by theoretical sample of three LGBTI youth and three registered nurses, all from Tshwane District, Gauteng Province, South Africa. Constant comparative data analysis was done. Codes, categories, and the core category were conceptualised. The substantive theory that emerged from this study explains three phases of facilitating LGBTI youth-inclusive care. Phase 1 involved recognising barrier to facilitating LGBTI youthinclusive care, reflecting the main concerns of participants when they experienced valueladen tension and conflict. Phase 2 involved recognising the need to change values and attitudes, and Phase 3 involved applying strategies to promote nurse-patient interaction reflect strategies employed by the nurses as the main resolutions to resolve those valueladen tension and conflict. A substantive theory presents reflections on how nurses might facilitate care and support for LGBTI patients in PHC, and other similar health care practices.