14727University of North Carolina at Charlotte, NC, USA.
311285The Pennsylvania State University, University Park, PA, USA.
Am J Hosp Palliat Care. 2021 Nov;38(11):1361-1377. doi: 10.1177/1049909120983283. Epub 2021 Jan 8.
The number of people with cancer and the need for palliative care among this population is increasing in the United States. Despite this growing need, several barriers exist to the utilization of palliative care in oncology. The purpose of this study was to synthesize the evidence on the barriers to palliative care utilization in an oncology population. A systematic review of literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, CINAHL, and Psych Info databases were used for the literature search. Articles were included if they: 1) focused on cancer, (2) examined and discussed barriers to palliative care, and c) were peer reviewed, published in English, and had an accessible full text. A total of 29 studies (8 quantitative, 18 qualitative, and 3 mixed-methods) were identified and synthesized for this review. The sample size of the included studies ranged from 10 participants to 313 participants. The barriers to palliative care were categorized into barriers related to the patient and family, b) barriers related to providers, and c) barriers related to the healthcare system or policy. The factors identified in this review provide guidance for intervention development to mitigate the existing barriers and facilitate the use palliative care in individuals with cancer.
美国癌症患者人数以及对该人群姑息治疗的需求正在增加。尽管存在这种日益增长的需求，但肿瘤学中姑息治疗的应用仍存在一些障碍。本研究旨在综合姑息治疗在肿瘤学人群中应用的障碍的证据。按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了系统的文献回顾。使用 PubMed、CINAHL 和 Psych Info 数据库进行文献检索。如果文章符合以下标准，则将其纳入：1）聚焦于癌症，2）检查和讨论姑息治疗的障碍，且 c）经过同行评审、以英文发表且可获取全文。本综述共纳入了 29 项研究（8 项定量研究、18 项定性研究和 3 项混合方法研究）。纳入研究的样本量从 10 名参与者到 313 名参与者不等。姑息治疗的障碍分为与患者和家属相关的障碍、与提供者相关的障碍和与医疗保健系统或政策相关的障碍。本综述中确定的因素为干预措施的制定提供了指导，以减轻现有障碍，促进癌症患者姑息治疗的应用。
