Seto Nielsen Lisa, Goldstein Zoë, Leung Doris, Lee Charlotte, Buick Catriona
School of Nursing, Faculty of Health, York University, Toronto, Canada.
School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
J Immigr Minor Health. 2019 Dec;21(6):1394-1405. doi: 10.1007/s10903-019-00882-w.
Approximately 30-40 million undocumented immigrants worldwide suffer restricted health care. A scoping review was conducted to determine what is known about this population's palliative end-of-life care experiences. The scoping review followed Arksey and O'Malley's methodological framework. Databases searched included CINAHL, Medline, ProQuest, Scopus, and PHRED. Search terms included uninsured care, palliative care, undocumented immigrants, and terminally ill. The search revealed limited peer-reviewed and grey literature on the topic. A total of six articles met inclusion criteria, of which four were case descriptions. Barriers to palliative care included lack of advanced care planning, lack of health insurance, poverty, fear of deportation, and limited English ability. Undocumented immigrants were more likely to have delayed access to and inadequate palliative end-of-life care. If palliative care is a human right, it is imperative that further research be conducted and policies put in place to better serve this vulnerable population at end-of-life.
全球约有3000万至4000万无证移民在医疗保健方面受到限制。开展了一项范围综述,以确定关于这一人群临终姑息治疗经历的已知情况。该范围综述遵循了阿克西和奥马利的方法框架。检索的数据库包括护理学与健康领域数据库(CINAHL)、医学期刊数据库(Medline)、ProQuest数据库、Scopus数据库和PHRED数据库。检索词包括无保险护理、姑息治疗、无证移民和绝症患者。检索发现关于该主题的同行评审文献和灰色文献有限。共有6篇文章符合纳入标准,其中4篇为病例描述。姑息治疗的障碍包括缺乏临终关怀规划、缺乏医疗保险、贫困、害怕被驱逐以及英语能力有限。无证移民更有可能延迟获得临终姑息治疗且治疗不足。如果姑息治疗是一项人权,那么必须开展进一步研究并制定政策,以便在临终时更好地服务于这一弱势群体。