Schneidman Jillian, Morel Sara B A, Ross Vanessa, Caminsky Natasha G, Grushka Jeremy, Wong Evan G
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Division of Trauma and General Surgery, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
World J Surg. 2025 Sep;49(9):2512-2522. doi: 10.1002/wjs.70034. Epub 2025 Aug 6.
The Circumpolar North is an expansive region that includes the northernmost parts of the Earth, extending across the Arctic and Subarctic zones. This area, characterized by its geographical remoteness, harsh climate, limited healthcare infrastructure, and diverse patient population, creates unique challenges for the provision and delivery of surgical care. Despite existing research in this field, there is a lack of comprehensive reviews summarizing patients' distinct experiences when accessing surgical care. This scoping review, therefore, aimed to fill this gap by mapping the current literature on the surgical experiences of patients from the Circumpolar North.
A scoping review methodology was employed to identify relevant, original, peer-reviewed articles across seven databases, with no limits on publication dates. Article screening and data extraction were undertaken independently by two reviewers. An iterative data analysis process was employed to categorize findings from the included studies and identify common patterns, key insights, and knowledge gaps.
A total of 17 studies were included in this review. Key factors influencing the surgical care experiences of patients from the Circumpolar North were identified across four domains: (1) logistical factors, including proximity to care centers, temporary accommodations, and financial costs; (2) psychosocial factors, such as experience of medical evacuations, separation from family, and reintegration into home communities; (3) cultural factors, encompassing navigating healthcare environments, language differences, and nonverbal communication; and (4) medical factors, including patient involvement, healthcare provider interactions, and continuity of care. Several studies also highlighted patients' experiences regarding innovative models aimed at improving locally based surgical care, such as telehealth and community-based strategies.
This review summarized the literature on the surgical care experiences of patients from the Circumpolar North. It offers insights into improving healthcare interactions and systems to better serve this population. It also highlights significant research gaps, particularly regarding Indigenous patient experiences and the impact of medical evacuations across diverse surgical specialties. Addressing these gaps through future research is crucial for deepening our understanding of surgical experiences of patients from the Circumpolar North and developing more effective, culturally competent strategies to improve patient care.
环北极地区是一个广阔的区域，包括地球的最北端，横跨北极和亚北极地带。该地区地理位置偏远、气候恶劣、医疗基础设施有限且患者群体多样，这给外科护理的提供和实施带来了独特的挑战。尽管该领域已有相关研究，但缺乏全面的综述来总结患者在接受外科护理时的独特经历。因此，本范围综述旨在通过梳理当前关于环北极地区患者外科手术经历的文献来填补这一空白。
采用范围综述方法，在七个数据库中识别相关的、原创的、经过同行评审的文章，对发表日期没有限制。由两名评审员独立进行文章筛选和数据提取。采用迭代数据分析过程对纳入研究的结果进行分类，并识别共同模式、关键见解和知识空白。
本综述共纳入17项研究。在四个领域确定了影响环北极地区患者外科护理经历的关键因素：（1）后勤因素，包括与护理中心的距离、临时住所和经济成本；（2）心理社会因素，如医疗后送经历、与家人分离以及重新融入家庭社区；（3）文化因素，包括适应医疗环境、语言差异和非语言交流；（4）医疗因素，包括患者参与、医疗服务提供者互动和护理连续性。几项研究还强调了患者在旨在改善当地外科护理的创新模式方面的经历，如远程医疗和基于社区的策略。
本综述总结了关于环北极地区患者外科护理经历的文献。它为改善医疗互动和系统以更好地服务这一人群提供了见解。它还突出了重大的研究空白，特别是关于原住民患者的经历以及不同外科专科中医疗后送的影响。通过未来的研究解决这些空白对于加深我们对环北极地区患者外科手术经历的理解以及制定更有效、具有文化胜任力的策略来改善患者护理至关重要。
