Division of Nursing, Midwifery & Social Work, The University of Manchester, UK.
School of Psychology, Bangor University, Wales, UK.
Gerontologist. 2021 Jul 13;61(5):e209-e227. doi: 10.1093/geront/gnaa023.
Understanding the influences of marginalized cultural and social identities as experienced by the African Caribbean diaspora within the context of dementia care is essential to minimize the gaps in current practice and policy in the health care setting. This study explores the impact of marginalized identities upon the meaning-making process, access to services and experience of care provisions through a scoping review and consultancy exercises with key stakeholders.
Fourteen databases were searched using key terms. Primary studies in English, any year, study design, and country of origin were eligible. Titles, abstracts, and full texts were screened for inclusion and data were extracted in stages. Thematic analysis was performed and the findings were discussed in a series of consultation meetings with people with dementia, carers, and health care professionals in Manchester (United Kingdom) and Jamaica.
The scoping review retrieved n = 1,989 research articles. Nineteen were included, most were qualitative (n = 14), 3 quantitative, and 2 mixed-method. The findings revealed limited insight into cultural and multiple individual identities in explaining conceptualization and service access. Consultation meetings confirmed these findings and highlighted differences in health care services and systems in the United Kingdom and Jamaica.
This study suggests there is a complex interaction of sociocultural processes that marginalize African Caribbean persons in and across various national settings within the context of dementia care. The study highlights the importance of acknowledging and addressing how prevalent racialized- and class-based divides and related marginalized social locations are reflected in inequities in access to and use of dementia services.
理解非裔加勒比散居人群在痴呆症护理背景下边缘化的文化和社会身份的影响，对于缩小当前医疗保健环境中实践和政策的差距至关重要。本研究通过范围综述和与关键利益相关者的咨询活动，探讨边缘化身份对意义建构过程、服务获取以及护理服务体验的影响。
使用关键词在 14 个数据库中进行搜索。纳入标准为英文发表、任意年份、研究设计和来源国的研究。对标题、摘要和全文进行筛选，以确定是否纳入，并分阶段提取数据。采用主题分析，并在曼彻斯特（英国）和牙买加与痴呆症患者、照顾者和医疗保健专业人员的一系列咨询会议中讨论研究结果。
范围综述检索到 n = 1989 篇研究文章。纳入了 19 篇文章，其中大多数为定性研究（n = 14），3 篇为定量研究，2 篇为混合方法研究。研究结果表明，在解释概念化和服务获取方面，对文化和多种个体身份的了解有限。咨询会议证实了这些发现，并强调了英国和牙买加的医疗保健服务和系统之间的差异。
本研究表明，在痴呆症护理背景下，存在着复杂的社会文化过程相互作用，使非裔加勒比人群在各种国家环境中处于边缘化地位。研究强调了承认和解决种族和阶级划分以及相关边缘化社会地位在获得和使用痴呆症服务方面的不平等现象的重要性。
