緩和ケアと医学

抽象的な

Barriers to Palliative Care Uptake in Culturally and Linguistically Diverse Populations: A Systematic Review

Mr. Mostafa Abasseri, Dr. Shakira Hoque, Dr. Slavica Kochovska, Dr. Kim Caldwell, Dr. Linda Sheahan, Prof Meera Agar, A/Prof Amany Zekry

Background and aim: Palliative care is essential for patients with life-limiting illnesses, as it enhances survival and quality of life. However, culturally and linguistically diverse individuals often struggle to access timely palliative care. This study investigates barriers to timely palliative care uptake in these populations.

Methodology: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary studies of different design exploring barriers to palliative care uptake in culturally and linguistically diverse populations were included, and data were analysed using narrative synthesis. Studies were appraised based on methodological quality and quality of reporting using the assessment criteria framework proposed by Kmet, Lee and Cook.

Data sources: PubMed, Medline, Embase, PsycINFO, EBMR and Emcare (February 2022).

Results: Of 2415 identified articles, 33 studies (30 qualitative, three quantitative) were included. Patients from diverse backgrounds reported barriers in four domains: negative attitudes towards palliative care, limited awareness of palliative care, poor understanding of their disease, and poor communication and collaboration with healthcare professionals (23 studies). Healthcare professionals reported barriers in four domains: lack of cultural understanding and awareness, lack of palliative care-specific training, emotions related to palliative care, and healthcare system/ structural barriers (19 studies).

Conclusion: Barriers to palliative care delivery in culturally and linguistically diverse cohorts mainly involve the themes of poor education and communication between patients and healthcare professionals. Developing and evaluating educational interventions targeting patients, caregivers, and healthcare professionals may improve palliative care uptake in these populations.