Malhotra Sonia, Christopher Michelle, Chowdry Rajasree Pia, Mossman Brenna, Cooke Amanda, Deblieux Josh, Simmons Cameron, Fisher Kiondra, Webb Jason, Hoerger Michael
Section of GIM/Geriatrics/Palliative Medicine, Deming Department of Medicine, Tulane University School of Medicine; University Medical Center, New Orleans, LA.
Section of GIM/Geriatrics/Palliative Medicine, Deming Department of Medicine, Tulane University School of Medicine; University Medical Center, New Orleans, LA.
Curr Probl Cancer. 2023 Oct 17:101024. doi: 10.1016/j.currproblcancer.2023.101024.
Palliative care (PC) is specialized medical care for people living with a serious illness. PC models have stressed pain and symptom management, communication that is patient- and family-centric and longitudinal support for families living with serious illness that is contiguous across multiple settings. Despite the benefits that PC provides from a patient, family and quality of care standpoint, several barriers and disparities exist. Included in these barriers are the lack of geographic access to PC programs as well as the focus on inpatient, hospital-based PC programs versus outpatient and home-based models. Workforce shortages, challenges with defining and designing PC, and racial, cultural and language barriers have all contributed to disparities within PC. This review article outlines PC disparities including geographic access challenges, cross-cultural barriers and symptom and communication specific disparities. We discuss the impact these inequities have on patients living with cancer.
姑息治疗（PC）是针对患有严重疾病的人群提供的专业医疗服务。PC模式强调疼痛和症状管理、以患者和家庭为中心的沟通，以及对患有严重疾病的家庭在多个环境中持续的纵向支持。尽管从患者、家庭和护理质量的角度来看，PC带来了诸多益处，但仍存在一些障碍和差异。这些障碍包括难以在地理上获得PC项目，以及侧重于住院的、基于医院的PC项目而非门诊和基于家庭的模式。劳动力短缺、在定义和设计PC方面的挑战，以及种族、文化和语言障碍，都导致了PC内部的差异。这篇综述文章概述了PC差异，包括地理获取挑战、跨文化障碍以及症状和沟通方面的特定差异。我们讨论了这些不平等对癌症患者的影响。
