Non-Clinical Interventions to Reduce Inequities in Palliative Care for 2SLGBTQ+ People: A Narrative Review
DOI :
https://doi.org/10.15273/hpj.v5i3.12477Mots-clés :
2SLGBTQ+, Palliative Care, End-of-life care, Interventions, InequitiesRésumé
Introduction: People who identify as Two-Spirit, lesbian, gay, bisexual, transgender, and/or queer (2SLGBTQ+) experience health disparities across the lifespan, including at end of life. Recently there has been recognition of the value of health promotion approaches to palliative care that address the social and structural determinants of a good death. Current reviews on 2SLGBTQ+ palliative care are primarily framed through a clinical, patient-provider level lens. Purpose: To understand how implemented and evaluated non-clinical interventions regarding palliative care for 2SLGBTQ+ people are described in the literature. Methods: A narrative review was conducted adhering to a systematic procedure. Six relevant databases were searched, and 1,547 records were screened by two independent reviewers. To be eligible for inclusion, studies had to describe one or more implemented and evaluated non-clinical intervention that addressed at least one inequity or barrier to palliative care for 2SLGBTQ+ people. Charted data was analyzed using inductive content analysis. The socio-ecological model (SEM) was used to critically examine findings. Results: Six studies were included for review. Examples of non-clinical interventions across various settings and multiple socio-ecological levels were noted. We identified four overarching themes to describe how non-clinical interventions reduce inequities in palliative care for 2SLGBTQ+ people. Conclusion: This review revealed gaps in interventions at organizational, community, and public policy levels. Future research should map efforts specific to the Canadian context and empower 2SLGBTQ+ communities to evaluate and report on the interventions they lead. A trauma-informed intersectional approach should be used in the design of interventions with and for 2SLGBTQ+ community members.
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