Understanding Black Women's Perspectives and Experiences of Cervical Cancer Screening: A Systematic Review and Qualitative Meta-synthesis.

Cervical cancer is the third most common gynecological cancer. Effective population-based cervical cancer screening programs exist, but improvements in morbidity and mortality continue to demonstrate racial disparities. For example, Black women are 41% more likely to develop cervical cancer than White women and are 75% more likely to die from it. It is therefore important to understand whether these inequities in cervical cancer outcomes are related to differential access and uptake of screening programs. In this systematic review and qualitative meta-synthesis, we used an intersectional lens to understand Black women's experiences and perspectives of cervical cancer screening (CCS). We identified 12 factors related to the perspectives and experiences of Black women participating in CCS. Understanding Black women's experiences and perspectives of CCS can help individual clinicians and policymakers implement CCS in a way that is culturally appropriate and cognizant of structural oppression.

Clinician responses to legal requests for hastened death: a systematic review and meta-synthesis of qualitative research.

BACKGROUND: The legalisation of medical assistance in dying in numerous countries over the last 20 years represents a significant shift in practice and scope for many clinicians who have had little-to-no training to prepare them to sensitively respond to patient requests for hastened death. AIMS: Our objective was to review the existing qualitative literature on the experiences of healthcare providers responding to requests for hastened death with the aim of answering the question: how do clinicians make sense of, and respond to patients' expressed wishes for hastened death? METHODS: We performed a systematic review and meta-synthesis of primary qualitative research articles that described the experiences and perspectives of healthcare professionals who have responded to requests for hastened death in jurisdictions where MAiD (Medical Assistance in Dying) was legal or depenalised. A staged coding process was used to identify and analyse core themes. RESULTS: Although the response to requests for hastened death varied case-by-case, clinicians formulated their responses by considering seven distinct domains. These include: policies, professional identity, commitment to patient autonomy, personal values and beliefs, the patient-clinician relationship, the request for hastened death and the clinician's emotional and psychological response. CONCLUSION: Responding to a request for hastened death can be an overwhelming task for clinicians. An approach that takes into consideration the legal, personal, professional and patient perspectives is required to provide a response that encompasses all the complexities associated with such a monumental request.