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儿科心理社会临终服务提供中的种族差异:系统评价。

Racial Disparities in the Provision of Pediatric Psychosocial End-of-Life Services: A Systematic Review.

机构信息

Department of Human Development, Family Studies, and Counseling, Texas Woman's University, Denton, Texas, USA.

Eliot-Pearson Department of Human Development and Child Studies, Tufts University, Medford, Massachusetts, USA.

出版信息

J Palliat Med. 2022 Oct;25(10):1510-1517. doi: 10.1089/jpm.2021.0476. Epub 2022 May 18.

Abstract

When compared with White patients, racial and ethnic minorities experience greater barriers to quality end-of-life care. Each year, approximately 52,000 children die in the United States, yet little is known about the disparities in pediatric palliative care, especially when looking at psychosocial palliative care services such as those provided by child life specialists, social workers, and pediatric psychologists. In an effort to consolidate and synthesize the literature on this topic for psychosocial professionals working with children and families confronting a life-threatening diagnosis, a review was conducted. This work was a systematic review of several academic databases that were searched from January 2000 to December 2020 for studies exploring disparities in pediatric end-of-life services and written in English. This review was conducted in the United States. The search yielded 109 articles, of which 16 were included for review. Three psychosocial researchers independently reviewed, critically appraised, and synthesized the results. Emerging themes from the literature ( = 16) include service enrollment, decision making, and communication. Results highlight a lack of research discussing psychosocial variables and the provision of psychosocial services. Despite this gap, authors were able to extract recommendations relevant to psychosocial providers from the medical-heavy literature. Recommendations call for more research specific to possible disparities in psychosocial care as this is vital to support families of all backgrounds who are confronting the difficulties of pediatric loss.

摘要

与白人患者相比,少数族裔和少数民族在获得高质量临终关怀方面面临更大的障碍。每年,美国约有 5.2 万名儿童死亡,但人们对儿科姑息治疗的差异知之甚少,尤其是在关注儿童生活专家、社会工作者和儿科心理学家提供的心理社会姑息治疗服务时。为了整合和综合从事儿童和家庭面临危及生命诊断的专业人员在这个主题上的文献,进行了一项综述。这项工作是对从 2000 年 1 月至 2020 年 12 月期间搜索的几个学术数据库进行的系统回顾,以探索儿科临终服务中的差异,并以英文撰写。这项综述在美国进行。搜索结果产生了 109 篇文章,其中有 16 篇被纳入审查。三位心理社会研究人员独立审查、批判性评价并综合了结果。文献中的主题( = 16)包括服务注册、决策和沟通。结果突出表明,缺乏讨论心理社会变量和提供心理社会服务的研究。尽管存在这一差距,但作者还是能够从以医学为重点的文献中提取出与心理社会提供者相关的建议。建议呼吁进行更多针对心理社会护理中可能存在差异的研究,因为这对于支持所有背景的家庭应对儿童死亡的困难至关重要。

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