Youn Nayung, Sorensen Jamie, Howland Chelsea, Gilbertson-White Stephanie
Univeristy of Iowa, College of Nursing, IA, USA.
Department of Epidemiology, University of Iowa College of Public Health, IA, USA.
Clin Nurs Res. 2024 Jun;33(5):416-428. doi: 10.1177/10547738241232018. Epub 2024 Feb 20.
Social determinants of health (SDOH) are structural factors that yield health inequities. Within the context of cancer, these inequities include screening rates and survival rates, as well as higher symptom burden during and after treatment. While pain is one of the most frequently reported symptoms, the relationship between SDOHs and cancer pain is not well understood. The purpose of this study is to describe and synthesize the published research that has evaluated the relationships between SDOH and cancer pain. A systematic search of PubMed, CINAHL, and Embase was conducted to identify studies in which cancer pain and SDOH were described. In all, 20 studies met the inclusion criteria. In total, 14 studies reported a primary aim related to SDOH and cancer pain. Demographic variables including education or income were used most frequently. Six specific measurements were utilized to measure SDOH, such as the acculturation scale, the composite measure of zip codes for poverty level and blight prevalence, or the segregation index. Among the five domains of SDOH based on Healthy People 2030, social and community was the most studied, followed by economic stability, and education access and quality. The neighborhood and built environment domain was the least studied. Despite increasing attention to SDOH, the majority of published studies use single-dimension variables derived from demographic data to evaluate the relationships between SDOH and cancer pain. Future research is needed to explore the intersectionality of SDOH domains and their impact on cancer pain. Additionally, intervention studies should be conducted to address existing disparities and to reduce the incidence and impact of cancer pain.
健康的社会决定因素（SDOH）是导致健康不平等的结构性因素。在癌症背景下，这些不平等包括筛查率和生存率，以及治疗期间和治疗后的更高症状负担。虽然疼痛是最常报告的症状之一，但人们对SDOH与癌症疼痛之间的关系了解并不充分。本研究的目的是描述和综合已发表的评估SDOH与癌症疼痛之间关系的研究。对PubMed、CINAHL和Embase进行了系统检索，以识别描述癌症疼痛和SDOH的研究。共有20项研究符合纳入标准。总共14项研究报告了与SDOH和癌症疼痛相关的主要目的。最常使用的人口统计学变量包括教育程度或收入。使用了六种特定测量方法来测量SDOH，如文化适应量表、贫困水平和破败率的邮政编码综合测量法或隔离指数。在基于《健康人民2030》的SDOH的五个领域中，社会和社区领域研究最多，其次是经济稳定性以及教育机会和质量。邻里和建成环境领域研究最少。尽管对SDOH的关注日益增加，但大多数已发表的研究使用从人口数据中得出的单维变量来评估SDOH与癌症疼痛之间的关系。未来需要开展研究，以探索SDOH各领域的交叉性及其对癌症疼痛的影响。此外，应进行干预研究，以解决现有的差异，并降低癌症疼痛的发生率和影响。
