Clinical Competence of Nurses in Caring for LGBT Patients: A National Cross-Sectional Study.

Authors

Stanisław Manulik, Raúl Juárez-Vela, Christopher S Lee, Anthony Dissen, Izabella Uchmanowicz, Miłosz Lipieta, Piotr Karniej, Antonio Martinez-Sabater, Billy A Caceres, Michał Czapla

Published in

Journal of clinical nursing. Sep 22, 2026. Epub Sep 22, 2026.

Abstract

To assess LGBT-related clinical competence among nurses and identify sociodemographic and occupational factors associated with overall competence and its domains of clinical preparedness, attitudes, and knowledge.
Nationwide cross-sectional study.
A nationwide online cross-sectional study was conducted between January and May 2026 among 861 registered nurses. Participants completed the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) and a questionnaire assessing sociodemographic and occupational characteristics. Descriptive statistics and univariable and multivariable linear regressions identified factors associated with overall and domain-specific LGBT-related clinical competence.
This study followed the STROBE Statement.
The mean overall LGBT-DOCSS score was 4.10 ± 0.53 on a 1-7 scale, with higher scores indicating greater competence. Nurses reported the highest average scores for attitudes (5.78 ± 0.86) and the lowest for clinical preparedness (2.48 ± 0.79). Rural residence was consistently associated with lower overall LGBT-related clinical competence and lower competence across all three domains. Master's degree education was associated with higher overall competence and greater clinical preparedness. Nurses born in 1965-1994 reported lower clinical preparedness than those born in 1946-1964, whereas Generation Z nurses demonstrated higher knowledge. Working more than 200 h per month was associated with lower knowledge.
Although nurses reported generally positive attitudes towards LGBT patients, important gaps in clinical preparedness and knowledge remain. Rural residence emerged as the strongest and most consistent predictor of lower LGBT-related clinical competence.
Undergraduate nursing education and continuing professional development should strengthen LGBT health content, with particular emphasis on practical clinical skills and targeted educational support for nurses working in rural settings.
The findings identify modifiable factors associated with LGBT-related clinical competence among nurses and provide evidence to guide nursing education, continuing professional development, and workforce strategies that promote equitable, culturally competent care for LGBT patients worldwide.

PMID:
42772964
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.

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