Department of Health Sciences, Faculty of Health and Behavioural Sciences, Lakehead University, Lakehead University, 955 Oliver Rd., Thunder Bay, ON, P7B 5E1, Canada.
Centre for Education and Research On Aging and Health, Lakehead University, Thunder Bay, Canada.
BMC Palliat Care. 2024 Oct 12;23(1):243. doi: 10.1186/s12904-024-01560-x.
Health inequities exist across the healthcare continuum, significantly impacting 2SLGBTQIA + individuals. Palliative care presents unique challenges for sexual and gender minorities due to socio-cultural, psychological, and systemic barriers. The objective of this scoping review was to synthesize existing research on palliative care use among 2SLGBTQIA + individuals and identify common themes in the literature.
A literature review was conducted, focusing on articles published between 2010 and 2023 from the PubMed and CINAHL databases. Arksey and O'Malley's methodological framework for scoping reviews was applied to guide the review process.
A total of 31 studies were identified. A significant portion of the research originated in North America, with little research from outside the USA. Palliative care and end-of-life care were most used to describe care, though these terms were often not clearly defined. All studies included a focus on sexual and gender minorities, but there was considerable variation in the terminology used and a noticeable paucity of literature specifically addressing the needs of transgender and gender non-conforming individuals, or use of an intersectional approach in analysis. Key themes identified in the literature include discrimination in palliative care settings, disenfranchised grief experienced by care partners, and a lack of training in palliative care settings concerning the unique needs of 2SLGBTQIA + people utilizing palliative care services.
People identifying as 2SLGBTQIA + experience unique inequities in accessing and using palliative care services. To address these challenges, future initiatives should focus on developing identity-affirming palliative care settings, enhancing respect and support for care partners and found family, and ensuring healthcare providers are properly educated to provide care to this community. Future research is also needed that considers more diverse samples, as well as the impact of intersecting identities on the specific needs and challenges they face at end-of-life.
医疗保健服务的各个环节都存在健康不平等现象，这对 2SLGBTQIA+个人产生了重大影响。由于社会文化、心理和系统障碍，姑息治疗给性少数群体和性别少数群体带来了独特的挑战。本研究旨在综合现有的姑息治疗使用研究，确定文献中的常见主题。
对 PubMed 和 CINAHL 数据库中 2010 年至 2023 年期间发表的文章进行文献回顾。应用 Arksey 和 O'Malley 的综述方法框架来指导综述过程。
共确定了 31 项研究。其中很大一部分研究来自北美，来自美国以外的研究很少。姑息治疗和临终关怀最常用于描述护理，但这些术语的定义往往不明确。所有研究都集中在性少数群体和性别少数群体上，但使用的术语差异很大，很少有专门针对跨性别和性别不符合者需求的文献，或在分析中采用交叉方法。文献中确定的关键主题包括姑息治疗环境中的歧视、护理伙伴经历的被剥夺的悲伤，以及姑息治疗环境中缺乏针对利用姑息治疗服务的 2SLGBTQIA+人群的独特需求的培训。
自认为是 2SLGBTQIA+的人在获得和使用姑息治疗服务方面存在独特的不平等现象。为了解决这些挑战，未来的举措应侧重于建立认同身份的姑息治疗环境，增强对护理伙伴和原生家庭的尊重和支持，并确保医疗保健提供者得到适当的教育，为这一群体提供护理。还需要进行更多的研究，考虑更具多样性的样本，以及交叉身份对他们在临终时面临的具体需求和挑战的影响。
