Central Denmark Region, Aarhus, Denmark.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Psychooncology. 2023 Jun;32(6):862-874. doi: 10.1002/pon.6138. Epub 2023 Apr 19.
Patients with pre-existing severe mental disorders are significantly less likely to receive guideline-recommended cancer treatment and seems to have a significantly lower rate of cancer survival compared to patients with cancer without mental disorders.
To perform a systematic review on barriers at patient-, provider- and system-levels in cancer trajectories of patients with pre-existing severe mental disorders.
A systematic review was performed following the PRISMA guidelines (PROSPERO ID: CRD42022316020).
Nine eligible studies were identified. Barriers at patient-level included lack of self-care and ability to recognize physical symptoms and signs. Provider-level barriers included stigma from health care professionals on mental disorders, whereas system-level barriers included fragmented health care and consequences of this.
This systematic review found that barriers at patient-, provider- and system-levels exist in cancer trajectories for patients with severe mental disorders, causing disparities in cancer care. Further research is needed to improve cancer trajectories for patients with severe mental disorder.
与无精神障碍的癌症患者相比，患有先前存在的严重精神障碍的患者接受指南推荐的癌症治疗的可能性明显较低，且癌症生存率明显较低。
对先前存在严重精神障碍的癌症患者的癌症轨迹中的患者、提供者和系统层面的障碍进行系统评价。
按照 PRISMA 指南（PROSPERO ID：CRD42022316020）进行系统评价。
确定了 9 项符合条件的研究。患者层面的障碍包括缺乏自我护理以及识别身体症状和体征的能力。提供者层面的障碍包括卫生保健专业人员对精神障碍的污名化，而系统层面的障碍包括分散的卫生保健以及由此产生的后果。
本系统评价发现，严重精神障碍患者的癌症轨迹中存在患者、提供者和系统层面的障碍，导致癌症护理方面的差异。需要进一步研究以改善严重精神障碍患者的癌症轨迹。
