Surbone Antonella, Halpern Michael T
Department of Medicine, Division of Hematology & Medical Oncology, New York University Medical School, 550 First Avenue, BCD 556, New York, NY, 10016, USA.
Department of Health Services Administration and Policy, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., #533, Philadelphia, PA, 19122, USA.
Support Care Cancer. 2016 Dec;24(12):4831-4833. doi: 10.1007/s00520-016-3435-4. Epub 2016 Oct 6.
The number of individuals diagnosed with cancer is growing worldwide. Cancer patients from underserved populations have widely documented disparities through the continuum of cancer care. As the number of cancer survivors (i.e., individuals who have completed cancer treatment) from underserved populations also continue to grow, these individuals may continue to experience barriers to survivorship care, resulting in persistent long-term negative impacts on health and quality of life. In addition, there is limited participation of survivors from underserved populations in clinical trials and other research studies. To address disparities and change practices in survivorship care, a better understanding of the roles of both socioeconomic status (SES) and of culture in cancer care disparities and the relevance of these to providing high-quality care is needed. SES and culture often overlap but are not identical; understanding the impact of each is especially relevant to survivorship care. To enhance health equity among cancer survivors, clinicians need to practice culturally competent care, address cultural beliefs and practices that may influence survivors' beliefs and activities, gain awareness of historical patterns of medical care in the survivor's community, and consider how barriers to cross-cultural communications may hinder communication in clinical settings. While the design and implementation of survivorship care programs emphasizing effectiveness and equity is complex and potentially time consuming, it is critical for providing optimal care for all survivors, including those from the most vulnerable populations.
全球范围内，被诊断患有癌症的人数正在增加。来自医疗服务不足人群的癌症患者在整个癌症治疗过程中存在广泛记录的差异。随着来自医疗服务不足人群的癌症幸存者（即完成癌症治疗的个体）数量也在持续增长，这些个体可能在生存护理方面继续面临障碍，从而对健康和生活质量产生长期持续的负面影响。此外，医疗服务不足人群的幸存者参与临床试验和其他研究的比例有限。为了解决差异问题并改变生存护理的做法，需要更好地理解社会经济地位（SES）和文化在癌症护理差异中的作用以及它们与提供高质量护理的相关性。社会经济地位和文化常常相互重叠但并不相同；了解各自的影响对于生存护理尤为重要。为了提高癌症幸存者之间的健康公平性，临床医生需要实施具有文化胜任力的护理，处理可能影响幸存者信念和活动的文化信仰及做法，了解幸存者社区的医疗护理历史模式，并考虑跨文化交流障碍如何可能阻碍临床环境中的沟通。虽然强调有效性和公平性的生存护理计划的设计和实施复杂且可能耗时，但为所有幸存者，包括最脆弱人群的幸存者提供最佳护理至关重要。
