Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa.
Global Health. 2020 Mar 18;16(1):23. doi: 10.1186/s12992-020-00553-8.
Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low- and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care.
To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa.
A scoping review was performed following the method of Arksey and O'Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT).
A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for full-article screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care.
Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.
在全球范围内，肺癌是最常见的癌症和癌症相关死亡的原因，占所有死亡人数的近五分之一。许多中低收入国家的卫生系统，包括撒哈拉以南非洲地区，组织结构薄弱，导致肺癌患者从诊断到姑息治疗的连续护理过程中的延误。
绘制影响中低收入国家（包括撒哈拉以南非洲地区）从诊断到姑息治疗的肺癌连续护理过程中延误的卫生系统问题的证据图。
采用 Arksey 和 O'Malley 的方法进行了范围综述。使用 EBSCOhost 平台进行了系统搜索，对以下电子数据库进行了关键词搜索：PubMed/MEDLINE、Google Scholar、Science Direct、世界卫生组织（WHO）图书馆和灰色文献。筛选过程遵循纳入和排除标准。使用混合方法评估工具（MMAT）确定纳入研究的质量。
共筛选出 2886 篇文章，其中 236 篇符合本范围综述研究的纳入标准。此外，在摘要筛选后还排除了 155 篇文章。两名研究人员对 81 篇文章进行了全文筛选，其中 10 篇文章被选中进行综合的详细数据提取。这些研究也进行了方法学质量评估。所有纳入的研究均在中低收入国家进行，主要在亚洲、中东和拉丁美洲，发表时间在 2008 年 1 月至 2018 年 6 月之间。这 10 项纳入的研究至少描述了肺癌护理中的一个间隔。
需要减少整个连续护理过程中的等待时间，以改善获得医疗保健、优质护理、生存和患者结果的便利性，因为许多患者在多个医疗保健环境中仍面临着比推荐的更长的诊断和治疗肺癌的等待时间。多学科团队方法将有助于减少等待时间，并确保所有患者都能得到适当的护理。需要采取干预措施来解决中低收入国家肺癌护理中的延误问题。各级医疗保健提供者都应接受教育并具备识别肺癌症状和进行或转介进行适当诊断测试的技能。
