■患有获得性脑损伤(ABI)的种族化儿童和青年经常遭受多种形式的歧视。这项系统评价的目的是了解患有ABI的儿童和青年及其照顾者在医疗保健方面的种族差异。
■六个国际数据库(OvidMedline,Embase,健康之星,Psychinfo,Scopus,和WebofScience)进行了系统搜索同行评审的文章。研究由两名研究人员进行筛选,他们还进行了数据提取和质量评估。采用叙事综合方法对数据进行分析。
■在搜索中确定的8081项研究中,34符合纳入标准,其中涉及两个国家的838,052名脑损伤儿童和青年(或代表他们的照顾者)。在我们的综述中的研究中指出了以下主题:(1)获得护理方面的种族差异(即,诊断,入院,逗留时间,康复治疗);(2)ABI相关健康结果的种族差异(即功能结果和死亡率);和(3)影响种族差异的因素(即伤害来源,保险和支出,和交叉性)。
■我们的研究结果揭示了患有ABI的儿童和青少年之间的种族差异。进一步的研究应探索解决这种种族差异的解决方案以及解决这些问题的解决方案。
患有获得性脑损伤的种族化青年在获得护理和卫生保健方面遇到许多障碍和不平等,应该有助于解决卫生系统中的这种差距和差距。临床医生应熟悉影响获得性脑损伤结果种族差异的常见因素,包括损伤来源,保险类型和文化因素。需要与来自种族不同背景的患者合作以及在医疗保健提供者中提供文化上适当的护理方面的额外培训。需要作出更多努力,在个人和结构层面解决后天性脑损伤儿童和青年康复服务中继续存在的种族差异。
UNASSIGNED: Racial minoritized children and youth with acquired brain injury (ABI) often experience multiple forms of
discrimination. The purpose of this systematic
review was to understand the racial disparities in health care among children and youth with ABI and their caregivers.
UNASSIGNED: Six international databases (Ovid Medline, Embase, Healthstar, Psychinfo, Scopus, and Web of Science) were systematically searched for peer-reviewed articles. Studies were screened by two researchers who also conducted the data extraction and quality appraisal. A narrative synthesis approach was used to analyze the data.
UNASSIGNED: Of the 8081 studies identified in the search, 34 met the inclusion criteria, which involved 838,052 children and youth with brain injuries (or caregivers representing them) across two countries. The following themes were noted in the studies in our
review: (1) racial disparities in accessing care (i.e., diagnosis, hospital admission, length of stay, rehabilitation treatment); (2) racial disparities in ABI-related health outcomes (i.e., functional outcomes and mortality rates); and (3) factors affecting racial disparities (i.e., sources in injury, insurance and expenditures, and intersectionality).
UNASSIGNED: Our findings reveal the concerning racial disparities among children and youth with ABI. Further research should explore solutions for addressing such racial disparities and solutions to address them.
Racial minoritized youth with acquired brain injury experience many barriers and inequalities in accessing care and health care leaders should help to address such gaps and disparities in the health system.Clinicians should familiarize themselves with the common factors affecting racial disparities in acquired brain injury outcomes including sources of injury, types of insurance and cultural factors.Additional training in working with patients from racially diverse backgrounds and in providing culturally appropriate care among healthcare providers is needed.More efforts are needed to address racial disparities at the individual and structural levels that continue to exist in rehabilitation services for children and youth with acquired brain injury.