School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Rowan Research and Evaluation, Ottawa, Ontario, Canada.
Support Care Cancer. 2021 Nov;29(11):7029-7048. doi: 10.1007/s00520-021-06216-7. Epub 2021 May 24.
The purpose of this systematic review is to synthesize the evidence on the types of interventions that have been utilized by Indigenous Peoples living with cancer, and report on their relevance to Indigenous communities and how they align with holistic wellness.
A systematic review with narrative synthesis was conducted.
The search yielded 7995 unique records; 27 studies evaluating 20 interventions were included. The majority of studies were conducted in USA, with five in Australia and one in Peru. Study designs were cross-sectional (n=13); qualitative (n=5); mixed methods (n=4); experimental (n=3); and quasi-experimental (n=2). Relevance to participating Indigenous communities was rated moderate to low. Interventions were diverse in aims, ingredients, and outcomes. Aims involved (1) supporting the healthcare journey, (2) increasing knowledge, (3) providing psychosocial support, and (4) promoting dialogue about cancer. The main ingredients of the interventions were community meetings, patient navigation, arts, and printed/online/audio materials. Participants were predominately female. Eighty-nine percent of studies showed positive influences on the outcomes evaluated. No studies addressed all four dimensions of holistic wellness (physical, mental, social, and spiritual) that are central to Indigenous health in many communities.
Studies we found represented a small number of Indigenous Nations and Peoples and did not meet relevance standards in their reporting of engagement with Indigenous communities. To improve the cancer survivorship journey, we need interventions that are relevant, culturally safe and effective, and honoring the diverse conceptualizations of health and wellness among Indigenous Peoples around the world.
本系统评价的目的是综合关于癌症患者所采用的干预措施的证据，并报告其与原住民社区的相关性，以及它们如何与整体健康保持一致。
进行了系统评价和叙述性综合。
搜索产生了 7995 条独特的记录；纳入了 27 项评估 20 项干预措施的研究。大多数研究在美国进行，澳大利亚有 5 项，秘鲁有 1 项。研究设计为横断面研究（n=13）；定性研究（n=5）；混合方法研究（n=4）；实验研究（n=3）；准实验研究（n=2）。与参与的原住民社区的相关性被评为中等至低等。干预措施在目标、成分和结果方面具有多样性。目标涉及（1）支持医疗保健之旅，（2）增加知识，（3）提供心理社会支持，以及（4）促进关于癌症的对话。干预措施的主要成分是社区会议、患者导航、艺术和印刷/在线/音频材料。参与者主要是女性。89%的研究显示对评估的结果产生了积极影响。没有研究涉及整体健康的所有四个维度（身体、心理、社会和精神），这些维度在许多社区都是原住民健康的核心。
我们发现的研究代表了少数原住民国家和民族，并且在报告与原住民社区的参与方面没有达到相关性标准。为了改善癌症生存者的旅程，我们需要有针对性、文化安全且有效的干预措施，同时尊重全球原住民对健康和幸福的多样化概念。
