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用于解决癌症幸存者护理中健康差异的交叉性方法:一项系统的范围综述。

Intersectionality approaches to address health disparities in cancer survivorship care: a systematic scoping review.

作者信息

Seven Memnun, Pasalak Inciser Seyma, Grabowski Gina, Moraitis Ann Marie, Bagcivan Gulcan

机构信息

Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA.

Independent Researcher, Geldrop, Netherlands.

出版信息

Support Care Cancer. 2025 Aug 9;33(9):772. doi: 10.1007/s00520-025-09830-x.


DOI:10.1007/s00520-025-09830-x
PMID:40781502
Abstract

PURPOSE: The use of intersectionality in clinical and research frameworks offers a more multidimensional and holistic approach to the provision of cancer care to those experiencing health disparities. Therefore, we aimed to review the current literature on the use of an intersectionality approach in cancer care for those experiencing cancer health disparities. METHODS: We searched four databases, including PubMed, Web of Science, PyscINFO, and Scopus, in November 2024. This scoping review followed the methods and protocol outlined by the Joanna Briggs Institute (JBI) Methods Manual for evidence synthesis. RESULTS: Of 40 articles included in this review, most (80%, n = 34) employed a quantitative study design, including only three using surveys to collect data. Studies mostly used a retrospective cohort (25%, n = 10) or population-based cohort study design (n = 17) with mostly available datasets. Outcome measures mostly included "mortality" (32.5%, n = 13) and/or "survival" (27.5%, n = 11). However, well-being or quality of life (QOL) and/or its dimensions were measured in a few studies (20%, n = 8). Race and ethnicity are the most investigated identities (92.5%, n = 37) and mostly (n = 28) at the intersection of two or more identities such as socioeconomic status (SES), geographic location, sex/gender, age and their influence on a health outcome in most studies. CONCLUSION: There is a need for mixed or qualitative studies to better understand the lived experiences of people who have to navigate through barriers driven by intersecting identities and how they create support or cope with these associated barriers. Future efforts should produce empirical evidence to inform the development and refinement of an intersectionality framework to guide the development of interventions aiming to address the intersecting influence of different identities to improve cancer outcomes.

摘要

目的:在临床和研究框架中运用交叉性理论,为面临健康差异的人群提供癌症护理提供了一种更具多维性和整体性的方法。因此,我们旨在回顾当前关于交叉性方法在癌症护理中用于那些面临癌症健康差异人群的文献。 方法:我们于2024年11月检索了四个数据库,包括PubMed、科学网、心理学文摘数据库和Scopus。本综述性研究遵循乔安娜·布里格斯研究所(JBI)证据综合方法手册中概述的方法和方案。 结果:本综述纳入的40篇文章中,大多数(80%,n = 34)采用定量研究设计,其中只有3篇使用调查收集数据。研究大多采用回顾性队列研究(25%,n = 10)或基于人群的队列研究设计(n = 17),大多使用现有数据集。结果测量大多包括“死亡率”(32.5%,n = 13)和/或“生存率”(27.5%,n = 11)。然而,少数研究(20%,n = 8)测量了幸福感或生活质量(QOL)及其维度。种族和族裔是研究最多的身份特征(92.5%,n = 37),并且在大多数研究中,大多(n = 28)是在两个或更多身份特征的交叉点,如社会经济地位(SES)、地理位置、性别、年龄及其对健康结果的影响。 结论:需要进行混合或定性研究,以更好地了解那些必须应对由交叉身份特征驱动的障碍的人们的生活经历,以及他们如何创造支持或应对这些相关障碍。未来的努力应产生实证证据,为交叉性框架的开发和完善提供信息,以指导旨在解决不同身份特征的交叉影响以改善癌症结果的干预措施的开发。

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本文引用的文献

[1]
Intersection of Poverty and Rurality for Early-Onset Colorectal Cancer Survival.

JAMA Netw Open. 2024-8-1

[2]
Neighborhood-level deprivation and survival in lung cancer.

BMC Cancer. 2024-8-6

[3]
Prevalence of cancer survivors in the United States.

J Natl Cancer Inst. 2024-11-1

[4]
Equity in oncology care: addressing disparities in cancer treatment in Georgia.

Front Public Health. 2024

[5]
Intersection of Race, Rurality, and Income in Defining Access to Minimally Invasive Lung Surgery.

Ann Thorac Surg. 2025-2

[6]
Race/ethnicity and socioeconomic position in emergency department utilization in patients with hepatocellular carcinoma.

Future Oncol. 2024

[7]
The intersection of race and social determinants of health on clinical outcome of glioblastoma patients.

J Neurosurg. 2024-9-1

[8]
Social Determinants of Health and Cancer Care: An ASCO Policy Statement.

JCO Oncol Pract. 2024-5

[9]
Multiple myeloma incidence, mortality, and survival differences at the intersection of sex, age, and race/ethnicity: A comparison between Puerto Rico and the United States SEER population.

Cancer Epidemiol. 2024-4

[10]
Intersectionality in nursing research: A scoping review.

Int J Nurs Stud Adv. 2023-12

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