A grounded theory study exploring lesbian patient self-disclosure of sexual orientation in acute care

Abstract

<p><strong>Background:</strong> Lesbians are a vulnerable population that has experienced discrimination in health care. Evidence-based strategies for supporting lesbian self-disclosure of sexual orientation have been developed for primary care, but not for acute care settings.</p> <p><strong>Purpose:</strong> The purpose of this study was to develop a grounded substantive theory to describe the process involved in lesbian self-disclosure of sexual orientation in acute care settings. Philosophical Underpinning: The philosophical underpinning was grounded theory as described by Strauss and Corbin (1998).</p> <p><strong>Methods:</strong> Twelve lesbians who had been hospital inpatients or Emergency Department patients within the previous twelve months were individually interviewed about the process of self-disclosure of sexual orientation to acute care providers. Interviews were audiotaped and transcribed verbatim by the researcher and analyzed using open, axial, and selective coding.</p> <p><strong>Results:</strong> The Neese Theory of Lesbian Self-Disclosure in Health Care was identified that consisted of antecedent conditions, the core category of personal risking, and the causal condition of fear. Personal risking was a two-stage process used by participants to manage the fear of self-disclosure and consisted of an anticipatory and interactional phase. Participants calculated the risk of self-disclosure and selected one of four interactional stances in encounters with acute care providers.</p> <p><strong>Conclusion: </strong>The Neese Theory of Lesbian Self-Disclosure in Health Care could be used to guide more inclusive acute care nursing practices for lesbian clients.</p>