背景:支持性癌症护理对于减少撒哈拉以南非洲(SSA)当前癌症结局的差异至关重要。包括生存和生活质量低下,并最终实现癌症治疗的公平。这是第一篇综述,旨在评估SSA癌症患者未满足的支持性护理需求的程度,并确定其影响因素。
方法:六个电子数据库[CINAHL,Embase,Medline(Ovid),PsycINFO,PubMed,和Cochrane数据库图书馆]进行了系统搜索。包括解决未满足的支持性癌症护理需求的一个或多个领域的研究。研究结果采用叙事分析和荟萃分析进行分析,视情况而定。
结果:2732篇文献中有11篇被保留在综述中。在SSA中,对癌症护理的感知未满足需求的汇总患病率为63%(95%CI:45,81),59%(95%CI:45,72)用于健康信息和系统,58%(95%CI:42,74)用于心理,44%(95%CI:29,59)用于患者护理和支持,性占43%(95%CI:23,63)。年纪大了,女性性别,农村住宅,晚期癌症阶段,健康信息获取率低与支持性医疗领域内多种未满足需求的比率高有关.
结论:在SSA中,最佳癌症护理供应较低,多达三分之二的患者报告一个或多个领域的需求未得到满足.加强努力,发展全面和综合的支持性护理服务系统,是改善临床结果的关键,生存,SSA中癌症患者的生活质量。
BACKGROUND: Supportive cancer care is vital to reducing the current disparities in cancer outcomes in Sub-Saharan Africa (SSA), including poor survival and low quality of life, and ultimately achieving equity in cancer care. This is the first
review aimed to evaluate the extent of unmet supportive care needs and identify their contributing factors among patients with cancer in SSA.
METHODS: Six electronic databases (CINAHL, Embase, Medline [Ovid], PsycINFO, PubMed, and Cochrane Library of Databases] were systematically searched. Studies that addressed one or more domains of unmet supportive cancer care needs were included. Findings were analyzed using narrative analysis and meta-analysis, as appropriate.
RESULTS: Eleven articles out of 2732 were retained in the
review. The pooled prevalence of perceived unmet need for cancer care in SSA was 63% (95% CI: 45, 81) for physical, 59% (95% CI: 45, 72) for health information and system, 58% (95% CI: 42, 74) for psychological, 44% (95% CI: 29, 59) for patient care and support, and 43% (95% CI: 23, 63) for sexual. Older age, female sex, rural residence, advanced cancer stage, and low access to health information were related to high rates of multiple unmet needs within supportive care domains.
CONCLUSIONS: In SSA, optimal cancer care provision was low, up to two-thirds of patients reported unmet needs for one or more domains. Strengthening efforts to develop comprehensive and integrated systems for supportive care services are keys to improving the clinical outcome, survival, and quality of life of cancer patients in SSA.