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交叉性因素与公平的临终体验:快速综述

Intersectionality factors and equitable end-of-life experiences: rapid review.

作者信息

Hudson Briony F, Taylor Fiona, Jones Rini, Sagar Devi Rani, Driscoll Ruth, Carter Dominic, Royston Sam, Penny Alison

机构信息

Marie Curie Palliative Care Research Department, University College London, London, UK

Marie Curie, London, UK.

出版信息

BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2438-e2445. doi: 10.1136/spcare-2023-004658.

Abstract

BACKGROUND

Efforts to minimise inequity in palliative and end-of-life care (PEoLC) are well-researched. This is frequently explained by differences related to singular factors. The concept of intersectionality recognises that the combination of variables exacerbates disparities.

OBJECTIVE

To identify and review what is known about intersectionality's impact on experiences of PEoLC, including advance care planning (ACP).

METHODS

A rapid review with a narrative summary of peer-reviewed articles. Six electronic databases were searched for studies explicitly exploring the role of intersectionality in the experience of PEoLC and ACP for people with life-limiting or terminal illnesses, published in the last 10 years.

RESULTS

Identifying eligible papers was challenging. Of the 3738 papers found, only seven were eligible. Of the seven included papers, four explored the impact of intersectionality on access to and attitudes towards ACP. Two studies involved access to PEoLC and one considered quality of care received in the last year of life.

CONCLUSIONS

Understanding intersectionality is crucial for delivering personalised approaches to care and support. The relationship between intersecting factors and end-of-life experiences is complex and there is currently a paucity of studies considering this. The majority of existing literature addresses a narrow range of variables. Additionally, the lack of guidance on the application of intersectionality in research, makes it difficult to compare and synthesise findings. Further diverse action-orientated research is necessary to produce impactful evidence to inform future policy with the aim of reducing inequity in PEoLC.

摘要

背景

为尽量减少姑息治疗和临终关怀(PEoLC)中的不公平现象所做的努力已得到充分研究。这通常由与单一因素相关的差异来解释。交叉性概念认识到各种变量的组合会加剧差异。

目的

识别并综述关于交叉性对PEoLC体验的影响的已知情况,包括预先护理计划(ACP)。

方法

对同行评审文章进行快速回顾并进行叙述性总结。检索了六个电子数据库,以查找在过去10年中发表的明确探讨交叉性在PEoLC体验以及针对患有生命受限或晚期疾病的人的ACP中所起作用的研究。

结果

确定符合条件的论文具有挑战性。在找到的3738篇论文中,只有7篇符合条件。在纳入的7篇论文中,4篇探讨了交叉性对ACP的获取和态度的影响。两项研究涉及PEoLC的获取,一项研究考虑了生命最后一年所接受护理的质量。

结论

理解交叉性对于提供个性化的护理和支持方法至关重要。交叉因素与临终体验之间的关系很复杂,目前考虑这一点的研究很少。大多数现有文献涉及的变量范围狭窄。此外,缺乏关于交叉性在研究中的应用的指导,使得难以比较和综合研究结果。需要开展更多以行动为导向的多样化研究,以产生有影响力的证据,为未来政策提供参考,旨在减少PEoLC中的不公平现象。

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