对创伤性脑损伤和无家可归的临床实践指南中的公平考虑:系统性审查
Vincy Chan1,2,3, Maria Jennifer Estrella4, Sara Hanafy1,3
1KITE Research Institute-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
EClinicalMedicine
|September 4, 2023
概括
临床实践指南很少考虑无家可归和创伤性脑损伤 (TBI) 的公平性. 未来的指导方针必须整合这些人群,并让他们参与发展,以获得更好的护理.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 临床实践指南 (CPG) 往往忽视弱势群体,重点关注普遍治疗和成本效益.
- 本研究解决了将无家可归和创伤性脑损伤 (TBI) 纳入各自的CPG中的差距,并审查了公平考虑.
- 用PROGRESS-Plus框架来评估弱势群体在CPG中的纳入情况.
研究的目的:
- 评估无家可归者在TBI CPG和无家可归者在TBI CPG中的整合.
- 评估这些CPG在多大程度上考虑了公平和弱势群体.
- 确定改善弱势群体指导方针制定的优先事项.
主要方法:
- 通过使用多个数据库和搜索策略,对TBI和无家可归的CPG进行了系统审查.
- 使用定性内容分析来检查证据和公平考虑的整合.
- 权益评估工具被用来评估对弱势群体的考虑.
主要成果:
- 在58个TBI CPG和2个无家可归CPG中,只有3个TBI CPG整合了无家可归的证据.
- 无家可归的CPG承认TBI的患病率,并优先考虑TBI和无家可归的人.
- 在TBI CPG中,公平很少被解决,在无家可归 CPG中很少.
结论:
- 对TBI和无家可归者的CPG显示出严重缺乏公平考虑.
- 将无家可归和TBI的证据整合到各自的CPG中至关重要.
- 让弱势群体参与指导方针的制定和开展有针对性的研究是重要的优先事项.
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