Yee Carolyn J, Penumudi Aashritha, Lewinson Terri, Khayal Inas S
Department of Anthropology, Dartmouth College, Hanover, NH 03755, USA.
Thomas Jefferson High School for Science and Technology, Alexandria, VA 22312, USA.
Cancers (Basel). 2025 Jul 1;17(13):2209. doi: 10.3390/cancers17132209.
: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. : A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. : Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. : This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups.
临终癌症护理中的种族和族裔差异依然存在，导致提前护理规划（ACP）的比例较低、姑息治疗的可及性降低，以及少数族裔人群的患者预后较差。虽然先前的研究记录了这些不平等现象，但对于为解决这些问题而制定的具体干预措施却知之甚少，因此有必要对旨在改善种族和族裔人群临终护理的现有策略进行全面审查。本范围综述的目的是研究旨在解决美国临终癌症护理中种族和族裔差异的干预措施的范围、特征及其结果。2024年9月，在Ovid MEDLINE、CINAHL全文数据库（EBSCOhost）和Scopus（爱思唯尔）中对针对少数族裔人群的临终癌症护理干预措施进行了全面检索。两名独立评审员按照系统评价和Meta分析扩展版的范围综述（PRISMA-ScR）指南筛选标题、摘要和全文，纳入标准仅限于在美国进行并以英文发表的研究。在3104项筛选出的研究中，10项符合纳入标准。纳入的参与者仅来自拉丁裔（n = 6项研究）或黑人（n = 4项研究）人群。我们确定了四种类型的干预措施，包括针对患者、护理人员、研究人员和临床医生的沟通技巧（n = 2）、针对患者的教育项目（n = 1）、针对患者和护理人员的导航与支持项目（n = 3），以及针对卫生工作者和社区领袖的培训项目（n = 4）。最有效的干预措施是那些解决语言障碍、融入文化价值观并涉及受信任的社区人物的措施。基于信仰的模式在非裔美国患者中尤为成功，而双语导航和以家庭为中心的ACP干预措施对拉丁裔人群的影响最大。本综述强调了（1）针对特定少数族裔人群进行文化定制干预措施的重要性，以及（2）此类干预措施数量有限，且主要仅针对最大的少数族裔群体。
