Background: Pancreatic cancer is a challenging malignancy with an aggressive biology and limited treatment options, contributing to low survival rates. Supportive and palliative care play a key role in improving the quality of life and psychological distress for patients and their families. However, appropriate delivery and effectiveness of these interventions may be influenced by social determinants of health (SDOH). These factors create significant barriers for patients, influencing their access to care and ability to make informed decisions. This review explores the role of SDOH in supportive and palliative care of pancreatic cancer patients and identifies areas for improvement to enhance this type of care for vulnerable populations. Methods: A thorough narrative review was carried out to evaluate the influence of social determinants of health on supportive and palliative care in the management of pancreatic cancer, focusing on symptom management, psychosocial support, nutritional support, advance care planning, rehabilitation, functional support, and care coordination. Results: This review demonstrates that disparities exist. Black and Asian patients receive less pain medications; those with lower level of education struggle to access psychological support; Hispanic and Black patients often do not receive needed nutritional care; and end-of-life planning is less common among non-White and less-educated patients. Conclusions: SDOH significantly affects the experience and delivery of supportive and palliative care in pancreatic cancer patients, exacerbating inequities across multiple domains of care. Addressing these disparities requires coordinated efforts at clinical, organizational, and policy levels to ensure equitable access to care for all patients in their final phase of life. Integrating attention to SODH into care delivery models can improve outcomes and enhance quality of life for these patients.
背景：胰腺癌是一种具有侵袭性生物学特性且治疗选择有限的恶性肿瘤，导致患者生存率较低。支持性和姑息治疗在改善患者及其家属的生活质量与心理困扰方面发挥着关键作用。然而，这些干预措施的适当实施和效果可能受到健康社会决定因素的影响。这些因素为患者设置了显著障碍，影响其获得医疗服务的能力和做出知情决策的机会。本综述探讨了健康社会决定因素在胰腺癌患者支持性和姑息治疗中的作用，并确定了改善弱势群体此类护理的潜在方向。 方法：通过系统性的叙述性综述，评估健康社会决定因素对胰腺癌支持性和姑息治疗的影响，重点关注症状管理、心理社会支持、营养支持、预先护理计划、康复治疗、功能支持及护理协调等方面。 结果：本综述揭示了显著的治疗差异。黑人和亚裔患者获得的镇痛药物较少；教育水平较低的患者难以获得心理支持；西班牙裔和黑人患者常未能获得必要的营养护理；非白人和低教育水平患者的临终规划实施率较低。 结论：健康社会决定因素显著影响胰腺癌患者支持性和姑息治疗的体验与实施，加剧了多个护理领域的不平等现象。解决这些差异需要在临床、组织和政策层面协同努力，确保所有患者在生命终末期都能获得公平的医疗照护。将健康社会决定因素纳入护理实施模式，有望改善患者预后并提升其生活质量。
肿瘤(癌症)患者之家