Adverse Childhood Experiences, Preventive Care Utilization, and Patient-Nurse Trust Relationship Among Sexual and Gender Minority Individuals

Nurs Res. 2023 Nov-Dec;72(6):439-446. doi: 10.1097/NNR.0000000000000682. Epub 2023 Jul 25.

Abstract

Background: Individuals who identify as sexual and gender minorities often experience high rates of adverse childhood experiences and encounter discrimination and stigma in their interactions with healthcare providers, leading to low utilization of healthcare services. However, the relationship between adverse childhood experiences, preventive care utilization, and trust in nurses among sexual and gender minority individuals remains unclear.

Purpose: This study explored the relationship between adverse childhood experiences and preventive care use and assessed the potential interaction effects of trust in nurses between adverse childhood experiences and preventive care use among individuals from sexual and gender minorities.

Methods: A cross-sectional design was used. A sample of 160 self-reported individuals from sexual and gender minorities completed an electronic online survey. Multiple linear regression and moderation analyses were conducted to examine the association between adverse childhood experiences, preventive care utilization, and nurse trust.

Results: There was a significant negative relationship between adverse childhood experiences and preventive care utilization. There was also a significant positive relationship between trust and preventive care utilization. The results also indicated that trust in nurses moderated the relationship between adverse childhood experiences and preventive care utilization among sexual and gender minority individuals.

Discussion: A significant relationship was found between a high prevalence of adverse childhood experiences and low healthcare service utilization. Strengthening the trust relationship between nurses and sexual and gender minority individuals could serve as a potential intervention point, leading to improved health outcomes for this vulnerable population. Hence, enhancing trust in nurses could be a key factor in increasing healthcare service utilization and overall health outcomes.

MeSH terms

  • Adverse Childhood Experiences*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Trust