Health & health care for lesbian, bisexual and same sex attracted women |
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DIALOG PhD project |
Summary and Aims |
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Disclosure and attitudes towards lesbians: outcomes in general practice (DIALOG) is an Australian PhD study being conducted by Ruth McNair at the Department of General Practice, University of Melbourne. The project commenced in July 2004 and should be completed by the end of 2008. DIALOG is designed to develop an understanding of the patient-doctor
relationship between lesbian, bisexual and same-sex attracted women
and their general practitioner (GP). The experiences of general
practice care for same sex attracted women and patterns of disclosure
of sexual orientation are explored from both perspectives in interviews
with women and with GPs.
The project teamThe project team consists of three principal investigators: The project team is assisted by an advisory group [hyperlink to the advisory group section please], which is kept informed with regular project updates and meets approximately twice per year. Ruth McNair
Ruth is a general practitioner in Carlton, Melbourne, specialising
in lesbian and women’s health. She is also a Senior Lecturer
at the Department of General Practice, University of Melbourne.
Ruth also has an interest and expertise in medical education including
interprofessional education. She was the Director of Undergraduate
Studies at The Department of General Practice from 2001 to 2004.
She is currently chairing the Women’s Health Working Group
of the Royal Australian College of General Practitioner’s
Curriculum Review. She is maintaining a role in teaching at undergraduate
and postgraduate level throughout the PhD. Kelsey Hegarty
Kelsey is a general practitioner and part time Associate Professor responsible for postgraduate activities in the department. Her research interests are in women’s health in particular women’s emotional wellbeing (partner abuse, depression, counselling). Her research experience includes a doctoral thesis on measurement and prevalence of partner abuse in general practice. Methodological strengths include scale development, survey design and implementation in the general practice setting. Angela Taft
Angela is currently Senior Research Fellow at Mother and Child
Health Research, La Trobe University and an Honorary Fellow in the
Department of General Practice, University of Melbourne. She has
spent the last ten years researching, advocating change in and writing
about the public health system’s response to intimate partner
abuse/domestic violence and also reproductive health. She is Principal
Investigator of the NHMRC funded MOSAIC community randomised trial,
an Associate Investigator on the Australian Longitudinal Study of
Women’s Health, and national co-convenor of the Public Health
Association of Australia’s (PHAA) Women’s Health Special
Interest Group. Funding and supportFunding Ruth McNair has received a Primary Health Care Scholarship from the National Health and Medical Research Council (NHMRC) to undertake this research. This is a three-year scholarship, which commenced in July 2004. The project has also attracted a Family Medicine Education and Research Grant from the Royal Australian College of General Practitioners in 2004. Support Ruth is supported as a PhD student within the Department of General Practice, the University of Melbourne. The DIALOG project is affiliated with the diamond longitudinal project, also being conducted at the Department of General Practice. Research questionsThe DIALOG research questions are: 1. How do same sex attracted women and their general practitioner
(GP) experience their clinical relationship? 2. How is disclosure of non-heterosexuality negotiated between same sex attracted women and their GP? 3. What could be changed within the general practice settings to improve the health care experience of same sex attracted women?  top
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Theoretical frameworkThe DIALOG project is using a combination of hermeneutic phenomenology, critical theory and feminism as the theoretical framework. Patient-centred clinical care and the principle of seeking a holistic understanding of patients are regarded as fundamental to the patient-doctor relationship. MethodQualitative methodology is being used to answer the DIALOG research questions. Lesbian, bisexual and same sex attracted women and general practitioners (GPs) will participate in individual semi-structured interviews. Interviews will be fully transcribed. The interview transcripts will be analysed to understand the attitudes, behaviours and beliefs of each person interviewed and of the group as a whole. Findings will be presented to the community and to GPs through talks and conferences. They will be also available on the DIALOG website and submitted for publication in peer-reviewed journals. EthicsThe DIALOG project has been approved by the University of Melbourne Human Research Ethics Committee. Association with the diamond projectDIALOG is affiliated with the diamond project. Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) is a longitudinal study occurring in the Department of General Practice, University of Melbourne. Diamond study description “The diamond study will follow, over time, 900 people
who receive care in general practice to investigate the factors,
from the patients' and doctors' point of view, that are likely to
aid recovery from depression, and prevent further episodes.”
Diamond screening survey sexual orientation question:
Women selecting any option except exclusively heterosexual, and who were not eligible for diamond were eligible to be invited to the DIALOG study. The DIALOG project team is very grateful to the diamond team for the opportunity to be affiliated in this way.
The DIALOG Logo – the labyrinthRuth McNair chose the labyrinth as a symbol of the DIALOG project.
The labyrinth The labyrinth is an ancient design that has existed in many cultures since pre-historic times. For example it was described by the Celts as the Never Ending Circle and by the Native Americans as the Medicine Wheel. It has been used in many religious traditions. It is called the Kabala in mystical Judaism. It has had many uses, however a common use has been as a pathway for reflection and discovery. Unlike a maze, it has only one path winding from the outside to the centre, and then back to the outside. Description adapted from http://www.gracecathedral.org/labyrinth/
Used with permission from http://www.lessons4living.com/labyrinth.htm
Significance of the labyrinth to DIALOG The labyrinth within the woman’s head is a metaphor for life’s journey, a path to enlightenment and in particular the discovery of sexual orientation. Although the path is not hidden, nor is it a maze, it still needs to be travelled in order to find awareness of self. Having discovered herself, the woman then chooses whether to exit the labyrinth again and reveal her discovery to others. Similarly, the GP can actively choose to enter the labyrinth, with the woman’s permission, and also to become aware of the meaning of her sexual orientation for her life and health. TerminologyThere are many terms used to describe women’s sexual orientation. Sexual orientation is a complex phenomenon, containing multiple meanings including sexual behaviour, sexual attraction and sexual identity. It may be a choice or inherent, it may be a political statement or a completely personal state of being. Sexual orientation may be the predominant feature of the woman’s person or she may regard it as almost irrelevant to her identity. It can be fluid over time and can vary in its expression according to context. For any particular woman her sexual orientation may incorporate just one of these meanings, or it may include a mixture of all of them. There may be some incongruence between a woman’s behaviour, attraction and identity. The DIALOG project involves women who regard themselves as lesbian, gay, bisexual or queer. It also includes women who do not choose to label themselves, however whose same sex attraction has been a significant aspect of their life experience. There is no one term that encompasses all of these forms of sexual orientation apart from non-heterosexual. While the DIALOG team initially used this term to be as inclusive as possible, we have rejected this now as being inappropriate. |
Medieval
Labyrinth logo from