Introduction: 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.Methods: 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.Results: 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.Conclusions: 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.
引言：在临终癌症护理领域，种族与民族差异持续存在，导致少数族裔人群预先护理计划实施率较低、姑息治疗可及性不足以及患者结局较差。尽管既往研究已记录这些不平等现象，但针对这些差异所制定的具体干预措施仍缺乏系统认知，因此有必要对旨在改善种族与民族人群临终护理的现有策略进行全面梳理。本范围综述旨在系统考察美国为应对临终癌症护理中种族与民族差异所设计的干预措施的实施范围、特征及其成效。 方法：于2024年9月通过Ovid MEDLINE、CINAHL with Full Text (EBSCOhost)及Scopus (Elsevier)数据库对针对少数族裔的临终癌症护理干预措施进行系统性检索。两名独立评审员遵循系统综述与荟萃分析扩展版范围综述报告规范，对文献标题、摘要及全文进行筛选，仅纳入在美国开展并以英文发表的研究。 结果：在3104项筛查研究中，10项符合纳入标准。研究参与者仅来自拉丁裔（6项研究）或非裔（4项研究）人群。我们识别出四类干预措施：针对患者、照护者、研究人员及临床医生的沟通技能培训（2项）、患者教育项目（1项）、患者与照护者导航支持项目（3项），以及医护人员与社区领袖培训项目（4项）。最有效的干预措施集中于消除语言障碍、融合文化价值观及引入可信赖的社区关键人物。基于信仰的干预模式在非裔美国患者中成效显著，而双语导航服务与以家庭为中心的预先护理计划干预对拉丁裔人群影响最为突出。 结论：本综述揭示：（1）针对特定少数族裔人群的文化适应性干预具有重要意义；（2）现有干预措施数量有限，且主要集中于规模最大的少数族裔群体。
肿瘤(癌症)患者之家