Kucukkaya Aycan, Goktas Polat, Semerci Şahin Remziye
Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Turkey.
UCD School of Computer Science, University College Dublin, Dublin, Ireland.
Semin Oncol Nurs. 2025 Jun;41(3):151852. doi: 10.1016/j.soncn.2025.151852. Epub 2025 Mar 31.
This systematic review aimed to explore and synthesize existing research on the barriers and inequalities in access to comprehensive care for pediatric oncology patients.
The search was conducted in five databases, including PubMed, Scopus, Web of Science, CINAHL, and APA PsycINFO in December 2024. This review followed PRISMA guidelines and included studies published up to December 2024. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields.
Thirteen articles in this systematic reviews identified key barriers to healthcare access, including inadequate infrastructure, workforce shortages, and financial constraints. Socioeconomic disparities, geographic inequities, and racial and ethnic inequalities further exacerbated these challenges. Lower family income was linked to worse outcomes, such as higher chronic graft-versus-host disease rates and late-stage cancer diagnoses. Cross-border residency, clinical trial underrepresentation, and insufficient clinician training also contributed to disparities. Proposed solutions included psychosocial screening, workforce development, financial toxicity mitigation, and policy reforms.
This review highlights the complex and multifaceted barriers affecting equitable access to comprehensive care for pediatric oncology patients. Using a multidimensional perspective, such as the National Institute on Minority Health and Health Disparities Research Framework, our findings suggest that disparities stem from interconnected social, economic, and systemic factors. Addressing these challenges requires a comprehensive, structural, and patient-centered approach to promote equitable healthcare access.
This review underlines the critical role of nursing advocacy, education, and interdisciplinary collaboration in promoting equitable care and addressing disparities within this vulnerable population.
本系统评价旨在探索并综合现有的关于儿科肿瘤患者获得全面护理的障碍和不平等问题的研究。
于2024年12月在五个数据库进行检索，包括PubMed、Scopus、Web of Science、CINAHL和APA PsycINFO。本评价遵循PRISMA指南，纳入截至2024年12月发表的研究。使用来自不同领域的评估初级研究论文的标准质量评估标准对研究质量进行评估。
本系统评价中的13篇文章确定了获得医疗服务的关键障碍，包括基础设施不足、劳动力短缺和经济限制。社会经济差异、地理不平等以及种族和民族不平等进一步加剧了这些挑战。家庭收入较低与较差的结果相关，如较高的慢性移植物抗宿主病发生率和晚期癌症诊断率。跨境居住、临床试验代表性不足以及临床医生培训不足也导致了差异。提出的解决方案包括心理社会筛查、劳动力发展、减轻经济毒性和政策改革。
本评价强调了影响儿科肿瘤患者公平获得全面护理的复杂多方面障碍。从多维视角，如美国国立少数族裔健康与健康差异研究所的研究框架来看，我们的研究结果表明，差异源于相互关联的社会、经济和系统因素。应对这些挑战需要采取全面、结构化且以患者为中心的方法来促进公平的医疗服务可及性。
本评价强调了护理倡导、教育和跨学科合作在促进公平护理以及解决这一弱势群体中的差异方面的关键作用。
