School of Health Sciences, University of Surrey, Guildford, UK
School of Health Sciences, University of Surrey, Guildford, UK.
BMJ Open. 2023 Jan 27;13(1):e066637. doi: 10.1136/bmjopen-2022-066637.
Persistent inequalities in cancer care and cancer outcomes exist within and between countries. However, the evidence pertaining to the root causes driving cancer inequalities is mixed. This may be explained by the inadequate attention paid to experiences of patients with cancer living at the intersection of multiple social categories (eg, social class, ethnicity). This is supported by the intersectionality framework. This framework offers an alternative lens through which to analyse and understand how these interlocking systems of oppression uniquely shape the experiences of patients with cancer and drive inequalities. In this protocol, we outline a scoping review that will systematically map what is known about the relationship between intersectionality and inequalities in care experience and cancer outcomes of patients with cancer; and to determine how the intersectionality framework has been applied in studies across the cancer care pathway and across countries.
This study will be guided by Arksey and O'Malley's, and Levac 's frameworks for scoping reviews. We will identify and map the evidence on cancer inequalities and intersectionality from 1989 to present date. Electronic databases (EMBASE, PsychINFO, CINAHL, Medline, Web of Science, ProQuest) and a systematic search strategy using a combination of keywords and Boolean operators AND/OR will be used to identify relevant studies. Screening of eligible papers and data extraction will be conducted by two independent reviewers, and disagreements resolved by discussion with the research team. We will use an iterative process to data charting using a piloted form. Findings will be collated into a narrative report.
Ethical approval is not required since data used are from publicly available secondary sources. Findings will be disseminated through peer-reviewed journals, conferences and stakeholder meetings. Further, findings will inform the next phases of a multistage research project aimed at understanding inequalities among patients with breast cancer.
在国家内部和国家之间,癌症护理和癌症结果仍然存在不平等现象。然而,与导致癌症不平等的根本原因相关的证据是混杂的。这可能是由于对处于多个社会类别(例如社会阶层、族裔)交叉点的癌症患者的经历关注不足所致。这一观点得到了交叉性框架的支持。该框架提供了一个替代视角,通过该视角可以分析和理解这些相互交织的压迫系统如何独特地塑造癌症患者的体验并导致不平等。在本方案中,我们概述了一项范围性综述,该综述将系统地描绘出交叉性与癌症患者护理体验和癌症结局不平等之间关系的已知内容;并确定交叉性框架在癌症护理路径和国家范围内的研究中是如何应用的。
本研究将遵循 Arksey 和 O'Malley 的以及 Levac 的范围性综述框架。我们将从 1989 年至今,确定和描绘癌症不平等和交叉性方面的证据。将使用电子数据库(EMBASE、PsychINFO、CINAHL、Medline、Web of Science、ProQuest)和系统搜索策略,结合关键词和布尔运算符 AND/OR 来识别相关研究。两名独立审查员将对合格论文进行筛选和数据提取,如有分歧,则通过与研究团队讨论解决。我们将使用经过试点的表格进行迭代数据图表制作。将通过叙述性报告汇总研究结果。
由于使用的数据来自公开的二手资料,因此不需要伦理批准。研究结果将通过同行评议的期刊、会议和利益相关者会议进行传播。此外,研究结果将为下一阶段的多阶段研究项目提供信息,该项目旨在了解乳腺癌患者之间的不平等现象。