目的:本系统评价的目的是综合癌症患者所使用的干预措施类型的证据,并报告它们与土著社区的相关性以及它们如何与整体健康保持一致。
方法:进行叙述性综合的系统综述。
结果:搜索产生了7995条独特记录;纳入了27项研究,评估了20项干预措施。大多数研究是在美国进行的,五个在澳大利亚,一个在秘鲁。研究设计是横截面(n=13);定性(n=5);混合方法(n=4);实验(n=3);和准实验(n=2)。与参与的土著社区的相关性被评为中等至低。干预的目的多种多样,成分,和结果。涉及的目标(1)支持医疗保健之旅,(2)增加知识,(3)提供社会心理支持,(4)促进有关癌症的对话。干预措施的主要内容是社区会议,病人导航,arts,和印刷/在线/音频材料。参与者主要是女性。89%的研究显示了对评估结果的积极影响。没有研究涉及整体健康的所有四个维度(身体,心理,社会,和精神)是许多社区土著健康的核心。
结论:我们发现的研究代表了少数土著民族和人民,并且在报告与土著社区的接触时不符合相关标准。为了改善癌症生存之旅,我们需要相关的干预措施,文化上安全有效,并尊重世界各地土著人民对健康和保健的不同概念。
OBJECTIVE: The purpose of this systematic review is to synthesize the evidence on the types of interventions that have been utilized by Indigenous Peoples living with cancer, and report on their relevance to Indigenous communities and how they align with holistic wellness.
METHODS: A systematic review with narrative synthesis was conducted.
RESULTS: The search yielded 7995 unique records; 27 studies evaluating 20 interventions were included. The majority of studies were conducted in USA, with five in Australia and one in Peru. Study designs were cross-sectional (n=13); qualitative (n=5); mixed methods (n=4); experimental (n=3); and quasi-experimental (n=2). Relevance to participating Indigenous communities was rated moderate to low. Interventions were diverse in aims, ingredients, and outcomes. Aims involved (1) supporting the healthcare journey, (2) increasing knowledge, (3) providing psychosocial support, and (4) promoting dialogue about cancer. The main ingredients of the interventions were community meetings, patient navigation, arts, and printed/online/audio materials. Participants were predominately female. Eighty-nine percent of studies showed positive influences on the outcomes evaluated. No studies addressed all four dimensions of holistic wellness (physical, mental, social, and spiritual) that are central to Indigenous health in many communities.
CONCLUSIONS: Studies we found represented a small number of Indigenous Nations and Peoples and did not meet relevance standards in their reporting of engagement with Indigenous communities. To improve the cancer survivorship journey, we need interventions that are relevant, culturally safe and effective, and honoring the diverse conceptualizations of health and wellness among Indigenous Peoples around the world.