PDF(Pubmed)
Abstract：
A large proportion of patients with sickle cell disease (SCD) identify as Black or African American (AA). Social bias and stigma in healthcare outcomes for children with SCD are impossible to explore without considering the impact of racial/cultural identity, socioeconomic status (SES), and geography. It is important to understand the current influences of social movements, expanded health insurance coverage, and telehealth on these variables when considering healthcare outcomes for patients with SCD. The objective of this study was to determine the roles of racial identity, SES, and geography in healthcare outcomes for the pediatric population of children with SCD in the United States (US). This study is a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases utilized included Cochrane, CINHAL, Medline, and Nursing and Allied Health Collection, all accessed through the EBSCO Information Services. Studies met the following inclusion criteria: published in English, pediatric patients residing in the US, and published between 2017 and 2022. Search terms included \"sickle cell\" AND \"pediatric\", which were then combined with \"minority\" OR \"racial\" OR \"rural\" OR \"urban\" OR \"poverty\" OR \"income\" OR \"socioeconomic status\". The initial search yielded 635 unique articles, with 17 articles meeting full inclusion criteria. Overall, it was clear that there are examples of positive effects of race, low SES, and rural geographic location on positive health outcomes, though a large number of studies oscillated between showing negative associations or no association at all. Barriers to care for patients with SCD are multifaceted, making it difficult to isolate and analyze the impact of individual variables. Many studies demonstrated the significance of family, community, and institutional relationships as positive support for patients with SCD. This review highlights the need for additional research on the healthcare outcome benefits of patient/familial support groups aiming to bring together patients who share racial experience and SCD diagnosis regardless of SES and geography.
摘要：
大部分镰状细胞病（SCD）患者被确定为黑人或非裔美国人（AA）。如果不考虑种族/文化认同的影响，就不可能探索SCD儿童医疗保健结果中的社会偏见和污名。社会经济地位(SES)，和地理。重要的是要了解当前社会运动的影响，扩大医疗保险覆盖面，在考虑SCD患者的医疗结果时，这些变量的远程医疗。这项研究的目的是确定种族认同的作用，SES,和地理在美国SCD儿童儿科人群的医疗保健结果(US)。本研究是根据系统审查和荟萃分析（PRISMA）指南的首选报告项目进行的范围审查。使用的数据库包括Cochrane，CINHAL,Medline,和护理和联合健康收藏，全部通过EBSCO信息服务访问。研究符合以下纳入标准：以英语出版，居住在美国的儿科患者，并在2017年至2022年之间发布。搜索词包括“镰状细胞”和“儿科”，然后将其与“少数民族”或“种族”或“农村”或“城市”或“贫困”或“收入”或“社会经济地位”相结合。最初的搜索产生了635篇独特的文章，17篇文章符合完全纳入标准。总的来说,很明显，有种族积极影响的例子，低SES，和农村地理位置对积极健康结果的影响，尽管大量研究在显示负相关或根本没有关联之间摇摆不定。护理SCD患者的障碍是多方面的，这使得难以分离和分析单个变量的影响。许多研究证明了家庭的重要性，社区,和机构关系作为对SCD患者的积极支持。这篇综述强调了对患者/家族支持小组的医疗保健结果益处进行额外研究的必要性，目的是将具有种族经验和SCD诊断的患者聚集在一起，无论SES和地理位置如何。
