Michał Czapla, Bartłomiej Stańczykiewicz, Donata Kurpas, Izabella Uchmanowicz, Bartosz Uchmanowicz, Raúl Juárez-Vela, Piotr Karniej
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引用次数: 0
Abstract
Background: The Lesbian, Gay, Bisexual, Transgender, and Queer individuals frequently encounter disparities in healthcare access, quality and inclusivity. Despite growing awareness of these challenges, Poland has lacked a psychometrically validated tool to assess the experiences of sexual and gender minorities in clinical settings.
Objectives: This study aimed to develop and validate the LGBTQ+ Healthcare Experiences Scale (LGBTQ+ HCES) tailored to the Polish context.
Material and methods: A multi-phase cross-sectional study was conducted in 2025. The initial pool of items was developed through a narrative literature review and refined by 4 researchers with clinical and academic experience in LGBTQ+ health. Content validity was assessed using a 2-round Delphi process involving a multidisciplinary panel of experts (n = 12), who rated item clarity and relevance using Aiken's V. A pilot test with 30 LGBTQ+ participants confirmed comprehension and technical usability. The final 15-item instrument, comprising 3 subscales (Respect and Inclusivity, Discrimination and Microaggressions, Trust and Comfort), was administered to 172 LGBTQ+ individuals recruited via social media. Psychometric evaluation included descriptive analysis, confirmatory factor analysis (CFA) and reliability testing (Cronbach's á, McDonald's ů).
Results: Confirmatory factor analysis supported a 3-factor model comprising Respect and Inclusivity, Discrimination and Microaggressions, and Trust and Comfort. Model fit indices met recommended thresholds (root mean square error of approximation = 0.041, standardized root mean square residual = 0.057, comparative fit index = 0.998). All subscales demonstrated acceptable to strong internal consistency (á = 0.745-0.778; ů = 0.92). No significant floor or ceiling effects were found to compromise the scale's performance. All items showed positive item-total correlations and contributed meaningfully to their respective subscales.
Conclusions: The LGBTQ+ HCES is a valid, reliable and culturally grounded instrument for assessing healthcare experiences among LGBTQ+ populations in Poland. It holds promise for research, public health surveillance and health system quality improvement efforts to promote inclusive and equitable care.
期刊介绍：
Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly.
Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff.
Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj.
Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker.
The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition.
In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus.
Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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