Every urologist and oncologist should know about treating sexual and gender minority prostate cancer patients: translating research findings into clinical practice.
Every urologist and oncologist should know about treating sexual and gender minority prostate cancer patients: translating research findings into clinical practice.
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DOI：
10.21037/tau-20-1052
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发表时间：
2021-07
影响因子：
2
通讯作者：
Wright M
中科院分区：
文献类型：
--
作者：
Rosser BRS;Rider GN;Kapoor A;Talley KMC;Haggart R;Kohli N;Konety BR;Mitteldorf D;Polter EJ;Ross MW;West W;Wheldon C;Wright M
2016年，美国国立卫生研究院将性少数群体（SGM）指定为健康差异人群。第二年，美国临床肿瘤学会强调需要改善 SGM 人群接受的次优癌症和生存护理。目前还没有针对同性恋、双性恋和/或变性者前列腺癌患者的文化上合格的护理的循证培训计划。在这篇选择性综述中，我们总结了针对性少数前列腺癌幸存者的最大定量研究的结果，以及对美国 11 个城市的 NIH 工作人员、临床医生和癌症诊所的 65 次访谈的结果。该报告分为三个部分，并采用问答形式回答了 21 个与临床医生为 SGM 前列腺癌患者提供护理相关的问题。首先，我们确定了在 SGM 前列腺癌患者护理中与文化相关的特定人群问题。虽然已经出现了针对性少数前列腺癌患者的大量研究，但有关性别少数的文献仅限于单个病例报告，不足以为实践提供信息。本次审查涵盖电子病历中的定义、人口规模、文化和历史背景、性行为、人口隐形、性取向和性别认同（SOGI）、治疗提供中的差异和歧视证据。第二部分重点是促进循证、以患者为中心的护理。这包括评估性取向的现行做法、性取向披露的管理、如何解决性少数男性在治疗后遇到的常见问题、性少数患者的常见问题、尿失禁的管理、治疗期间和治疗后的艾滋病毒和性传播感染风险，以及预后较差的性少数患者亚组。然后，它确定了男性伴侣在前列腺癌支持方面的差异、性少数男性康复的最新研究、晚期前列腺癌的问题以及少数族裔患者应避免的事情。最后，我们研究了提供者和患者之间的文化鸿沟，倡导在与少数族裔患者合作时保持文化谦逊。培训计划和继续教育可以帮助提供者更加了解自己的文化假设，了解健康差异，能够提供优质护理，并使诊所更欢迎 SGM 患者。
In 2016, the NIH designated sexual and gender minorities (SGM) a health disparity population. The next year, the American Society of Clinical Oncology highlighted the need to improve the suboptimal cancer and survivorship care received by SGM populations. There are currently no evidence-based training programs in culturally competent care of prostate cancer patients who are gay, bisexual and/or transgender. In this selective review, we summarize findings from the largest quantitative studies focused on sexual minority prostate cancer survivors and from 65 interviews with NIH staff, clinicians, and cancer clinics in 11 US cities. The report is divided into three parts and uses a question and answer format to address 21 questions relevant to clinicians providing care to SGM prostate cancer patients. First, we identify population-specific issues that are culturally relevant in the care of SGM patients with prostate cancer. While a body of research has emerged on sexual minority prostate cancer patients, the literature on gender minorities is limited to single case reports and inadequate to inform practice. This review covers definitions, population size, cultural and historical context, sexual behavior, population invisibility, sexual orientation and gender identity (SOGI) in the electronic medical record, disparities and evidence of discrimination in treatment provision. The second part focuses on promoting evidence-informed, patient-centered care. This includes current practices in assessing sexual orientation, management of disclosure of sexual orientation, how to address common problems sexual minority men experience post-treatment, common questions sexual minority patients have, management of urinary incontinence, HIV and STI risk during and post-treatment, and sub-groups of sexual minority patients with worse outcomes. It then identifies how male partners differ in prostate cancer support, current research on rehabilitation for sexual minority men, issues in advanced prostate cancer, and things to avoid with minority patients. Finally, we examine the cultural divide between provider and patient, advocating for cultural humility when working with minority patients. Training programs and continuing education can help providers both to become more aware of their own cultural assumptions, informed about health disparities, and able to provide quality care, and to make clinics more welcoming to SGM patients.
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影响因子：
6.2
作者：
Bauer, Greta R.;Scheim, Ayden I.;Massarella, Carys
通讯作者：
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影响因子：
4.8
作者：
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影响因子：
4.8
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
4.5
作者：
Bauer GR;Scheim AI;Pyne J;Travers R;Hammond R
通讯作者：
Hammond R