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Review
. 2023 May 30;15(5):2824-2835.
doi: 10.21037/jtd-22-1613. Epub 2023 May 9.

Social determinants of health among family caregiver centered outcomes in lung cancer: a systematic review

Affiliations
Review

Social determinants of health among family caregiver centered outcomes in lung cancer: a systematic review

Dede K Teteh et al. J Thorac Dis. .

Abstract

Background: Lung cancer is the leading cause of cancer death globally. Both lung cancer patients and family caregivers (FCGs) have unmet quality of life (QOL) needs. An understudied topic in lung cancer research is the role of social determinants of health (SDOH) on QOL outcomes for this population. The purpose of this review was to explore the state of research on SDOH FCGs centered outcomes in lung cancer.

Methods: The databases PubMed/MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association (APA) PsycInfo were searched for peer-reviewed manuscripts evaluating defined SDOH domains on FCGs published within the last ten years. The information extracted using Covidence included patients, FCGs and study characteristics. Level of evidence and quality of articles were assessed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale.

Results: Of the 344 full-text articles assessed, 19 were included in this review. The social and community context domain focused on caregiving stressors and interventions to reduce its effects. The health care access and quality domain showed barriers and underuse of psychosocial resources. The economic stability domain indicated marked economic burdens for FCGs. Four interconnected themes emerged among articles on the influence of SDOH on FCG-centered outcomes in lung cancer: (I) psychological well-being, (II) overall quality of life, (III) relationship quality, and (IV) economic hardship. Notably, most participants in the studies were White females. The tools used to measure SDOH factors included primarily demographic variables.

Conclusions: Current studies provide evidence on the role of SDOH factors on lung cancer FCGs' QOL. Expanded utilization of validated SDOH measures in future studies would provide greater consistency in data, that could in turn inform interventions to improve QOL. Further research focusing on the domains of education quality and access and neighborhood and built environment should be carried out to bridge gaps in knowledge.

Keywords: Social determinants of health (SDOH); family caregivers (FCGs); lung cancer; quality of life (QOL).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1613/coif). LE reports payments from Lung Cancer Research Foundation and American Association of Thoracic Surgery. LE is a member of the scientific advisory board of Lung Cancer Research Foundation. LE sat on the health disparities advisory board of AstraZeneca in 2021. LE reports payments from AstraZeneca Pharmaceuticals for giving a presentation to the organization on Barriers to Lung Cancer Research (LCS) in July 2022. LE also reports payment from Gilead Oncology for giving a health equity presentation to the organization in March 2022. VS reports grants from National Cancer Institute and Patient-Centered Outcomes Research Institute. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Social determinants of health framework for lung cancer family caregivers.
Figure 2
Figure 2
PRISMA flow diagram includes the number of records at various steps including identification of studies, screening, and final list of records for data extraction and analysis.

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