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OBJECTIVES: To describe the extant literature on social determinants of health as they relate to the cancer disparities and to highlight the research findings relating to lesbian, gay, bisexual, and transgender (LGBT) populations. DATA SOURCES: Published scientific literature and clinical literature, and published reports from the World Health Organization and US Department of Health and Human Services. CONCLUSION: The larger literature on health inequities is moving beyond individual-level predictors of risk to evaluate the influence of social determinants of health on the persistent health inequalities in a population. As it has for other groups, additional research into social determinants of health for LGBT persons of color may play an important role in identifying and reducing cancer inequities for this group. IMPLICATIONS FOR NURSING PRACTICE: Increased awareness of the factors that contribute to health inequities for the LGBT population may provide insight into improving patient-provider relationships with LGBT patients. A large body of experiential and clinical knowledge positions nurses to conduct meaningfu l research to expand the current understanding of the social determinants of LGBT cancer health inequities. [ABSTRACT FROM AUTHOR]

Background: Sexual and gender minority (SGM) individuals experience elevated rates of depression due to exposure to unique social stressors associated with membership in a stigmatised minority group. Coping style has been shown to buffer or exacerbate responses to stress. To date, little is known about the risk or protective influence of coping styles on the relationships between stressors and depression in SGM populations., Aims: To examine the moderating effects of coping styles on the relationships between stressors and depression in Thai SGMs., Methods: This cross-sectional descriptive survey was conducted between March and August 2018 using in-person and online surveys. Convenience and snowball recruitment strategies were used. Standardised measures were selected according to the Minority Stress Model. Bivariate and multivariate analyses were conducted. Hayes's PROCESS macro was used to test for significant interactions., Results: Of the 411 participants, 40% of the participants reported symptoms of depression that were associated with multiple stressors. Problem-focused coping was reported by most participants (95.8%), followed by social support (83.1%) and avoidance (49.1%) coping. Problem-focused coping weakened the relationships between stressors and depression, whereas avoidance coping strengthened the relationships between depression and stress, loneliness and discrimination. Social support coping was negatively related to depression, with no statistically significant moderating effects., Conclusions: Problem-focused coping served to mitigate the influence of stressors on depression, whereas avoidance coping strategies exacerbated the impact. Nursing interventions aimed at improving problem-focused coping may reduce the negative consequences of stressors on the mental health of SGMs., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Loneliness is a significant risk factor for depression in adults. Sexual and gender minority (SGM) individuals are at risk for loneliness and depression due to stigma and discrimination. However, little is known about the influences of loneliness on the mental health of SGM populations. Guided by the Minority Stress and Integrative Mediation Frameworks, the authors aimed to examine loneliness's direct and indirect effects on the relationships between minority stressors and depression among Thai SGM adults. Data were drawn from a larger cross-sectional survey. Standardized measures of minority stressors (discrimination, victimization, identity concealment, and internalized sexual stigma), loneliness, and depression were selected and translated by expert panels. A convenience sample was recruited, and data were collected using online and in-person methods. Participants (N = 411, M = 29.5 years) were primarily male (90.5%), gay (79.3%), and cisgender (76.6%). More than 40% of participants reported clinically significant levels of loneliness (M = 38.59, standard deviation [SD] = 11.11) and depression (M = 9.46, SD = 8.43). Discrimination, identity concealment, and internalized sexual stigma were directly associated with loneliness (all p < 0.05). Minority stressors were significantly related to depression through indirect associations via loneliness accounting for 33%-54% of the total effect. Indirect effects (95% confidence interval) were 0.25 [0.12, 0.40] for discrimination, -0.41 [-0.67, -0.18] for identity concealment, and 0.42 [0.06, 0.79] for internalized sexual stigma. Loneliness was prevalent and played a mediating role in the associations between minority stressors and depression. Study findings have implications for the development of intervention research., (© 2022 Wiley Periodicals LLC.)

WHAT IS KNOWN ON THE SUBJECT?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study examined rates and predictors of suicidality in Thai LGBT adults. Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past-year suicidal ideation, while socio-demographic and health-related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand. Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours. Standardized measures of sexual orientation and gender identity should be included in all patient intake forms. In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority-specific stressors should be used. Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing., Abstract: INTRODUCTION: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists., Aim: To examine rates and predictors of suicidality among Thai LGBT adults (N = 411)., Method: Data collection was conducted via online and in-person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health-related factors, general and minority-specific stressors and suicidality were completed., Results: Thirty-nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12-month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤ .05, R 2 = 0.327). Past-year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p < .05, R 2  = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R 2  = 0.187)., Discussion: General and minority-specific stressors negatively impacted suicidality among LGBT participants., Implication for Practice: Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals., (© 2020 John Wiley & Sons Ltd.)