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女同性恋、男同性恋、双性恋、跨性别者及酷儿群体中患者视角下的癌症护理需求与经历:一项系统综述

Needs and experiences of cancer care in patients' perspectives among the lesbian, gay, bisexual, transgender and queer community: a systematic review.

作者信息

Chan Alex Siu Wing, Leung Lok Man, Wong Florence Kwai Ching, Ho Jacqueline Mei Chi, Tam Hon Lon, Tang Patrick Ming Kuen, Yan Elsie

机构信息

Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong.

Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.

出版信息

Soc Work Health Care. 2023 Jul-Dec;62(8-9):263-279. doi: 10.1080/00981389.2023.2226182. Epub 2023 Jun 20.

Abstract

Individuals within the Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) community who are diagnosed with cancer experience inequitable treatment in healthcare systems worldwide, resulting in dissatisfaction, communication challenges with healthcare providers, and a deep sense of disappointment. Stigma, discrimination, and perceived homophobia further heighten the risk of psychological and attitudinal disorders, including depression and suicidal tendencies, among LGBTQ cancer patients. To comprehensively assess the discrimination faced by LGBTQ cancer patients and gain deeper insights into their needs and experiences, we conducted a systematic review following PRISMA guidelines. We searched for relevant articles using specific keywords in reputable databases such as PubMed, Google Scholar, and PsycINFO. We rigorously evaluated article quality using the CASP (Critical Appraisal Skills Programme) checklist. From a total of 75 eligible studies, we carefully selected 14 studies, specifically examining LGBTQ cancer patients who were currently undergoing or had previously undergone cancer treatment. The studies revealed various factors, including unmet needs related to anxiety and depression, instances of discrimination, disparities in care, and inadequate support systems. A majority of patients expressed dissatisfaction with their cancer care and continued to encounter discrimination and disparities throughout their treatment journeys. Consequently, this led to heightened levels of anxiety, stress, depression, and negative perceptions of healthcare providers. Based on these findings, we recommend providing specialized training to social workers and healthcare providers. This training will equip them with the necessary skills and knowledge to deliver culturally sensitive care tailored to the unique needs of LGBTQ cancer patients. By addressing discrimination, reducing disparities, and fostering an inclusive environment, healthcare professionals can strive to ensure that LGBTQ cancer patients receive the care they deserve.

摘要

女同性恋、男同性恋、双性恋、跨性别者和酷儿(LGBTQ)群体中被诊断患有癌症的个体,在全球医疗系统中经历着不公平的治疗,导致不满、与医疗服务提供者沟通困难以及深深的失望感。耻辱感、歧视和感知到的恐同心理进一步增加了LGBTQ癌症患者出现心理和态度障碍的风险,包括抑郁和自杀倾向。为了全面评估LGBTQ癌症患者所面临的歧视,并更深入地了解他们的需求和经历,我们按照PRISMA指南进行了一项系统综述。我们在PubMed、谷歌学术和PsycINFO等知名数据库中使用特定关键词搜索相关文章。我们使用CASP(批判性评估技能计划)清单严格评估文章质量。从总共75项符合条件的研究中,我们精心挑选了14项研究,专门研究目前正在接受或以前接受过癌症治疗的LGBTQ癌症患者。这些研究揭示了各种因素,包括与焦虑和抑郁相关的未满足需求、歧视情况、护理差异以及支持系统不足。大多数患者对他们的癌症护理表示不满,并且在整个治疗过程中继续遭遇歧视和差异对待。因此,这导致焦虑、压力、抑郁水平升高以及对医疗服务提供者的负面看法。基于这些发现,我们建议为社会工作者和医疗服务提供者提供专门培训。这种培训将使他们具备必要的技能和知识,以便提供符合LGBTQ癌症患者独特需求的具有文化敏感性的护理。通过消除歧视、减少差异并营造一个包容的环境,医疗专业人员可以努力确保LGBTQ癌症患者得到他们应得的护理。

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