Faculty of Nursing, College of Health Sciences, University of Alberta, Third Floor Edmonton Clinic Health Academy, 11405 87 Avenue NW, Edmonton, AB, T6G 1C9, Canada.
Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South West Region, Cameroon.
Int J Equity Health. 2024 Apr 25;23(1):81. doi: 10.1186/s12939-024-02173-9.
Improving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population.
We undertook a scoping review using the framework by Arksey and O'Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. Searches were performed in the following bibliographic databases: Medline, EMBASE, PsycINFO via OVID, CINAHL via EBSCOhost, Scopus and Cochrane Library via Wiley. The search strategy was derived from three main concepts: (1) Black people; (2) Canada and Canadian provinces; (3) Palliative, hospice, or end-of-life care. No publication date or language limits were applied. Titles and abstracts were screened for eligibility by one reviewer and full text by two independent reviewers.
The search yielded 233 articles. Nineteen articles were selected for full-text review, and 7 articles met the inclusion criteria. These studies were published between 2010 and 2021, and conducted in the provinces of Ontario and Nova Scotia only. Studies used both quantitative and qualitative methods and included cancer decedents, next of kin, family caregivers and religious leaders. Sample sizes in various studies ranged from 6 - 2,606 participants. Included studies reported a general lack of understanding about palliative and end-of-life care, positive and negative experiences, and limited access to palliative and end-of-life care for Blacks, across all care settings.
Findings suggest limited knowledge of palliative care and inequities in access to palliative and end-of-life care for Blacks living with life-limiting illnesses in 2 Canadian provinces. There is an urgent need for research to inform tailored and culturally acceptable strategies to improve understanding and access to palliative care and end-of-life care among Blacks in Canada.
改善加拿大服务不足人群的公平性和及早获得姑息治疗是当务之急。对于生活在加拿大的黑人人群的姑息治疗和临终关怀的获得情况知之甚少。
我们采用 Arksey 和 O'Malley 的框架进行了范围界定审查，以确定在加拿大患有绝症的黑人中，姑息治疗和临终关怀的知识、获得差距和体验。合格的研究包括主要研究、讨论文件、书籍和报告。我们遵循了一位信息科学家制定的全面搜索策略。在以下文献数据库中进行了搜索：Medline、EMBASE、OVID 中的 PsycINFO、EBSCOhost 中的 CINAHL、Scopus 和 Wiley 中的 Cochrane Library。搜索策略源自三个主要概念：（1）黑人；（2）加拿大及其省份；（3）姑息治疗、临终关怀或临终关怀。没有应用出版日期或语言限制。由一名评审员筛选标题和摘要，两名独立评审员筛选全文。
搜索结果为 233 篇文章。19 篇文章被选为全文审查，7 篇文章符合纳入标准。这些研究发表于 2010 年至 2021 年期间，仅在安大略省和新斯科舍省进行。研究使用了定量和定性方法，包括癌症死者、近亲、家庭照顾者和宗教领袖。不同研究的样本量范围为 6 至 2606 名参与者。纳入的研究报告称，在所有护理环境中，黑人普遍对姑息治疗和临终关怀缺乏了解，对姑息治疗和临终关怀的体验有好有坏，获得姑息治疗和临终关怀的机会有限。
研究结果表明，在加拿大的两个省份，生活在患有绝症的黑人中，姑息治疗知识有限，获得姑息治疗和临终关怀的机会不平等。迫切需要开展研究，为加拿大黑人提供有关姑息治疗和临终关怀的理解和获得方面的信息，制定有针对性和文化上可接受的策略。
