RESUMO
OBJECTIVES: To present the ways in which race, ethnicity, class, gender, and sexual orientation interact in the context of cancer risk, access to care, and treatment by health care providers. Cancer risk factors, access to care, and treatment for lesbian, gay, bisexual, and transgender (LGBT) patients are discussed within the context of intersectionality and cultural humility. DATA SOURCES: Peer reviewed articles, cancer organizations, and clinical practice. CONCLUSION: LGBT patients have multiple identities that intersect to create unique experiences. These experiences shape their interactions with the health care system with the potential for positive or negative consequences. More data is needed to describe the outcomes of those experiences and inform clinical practice. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have an obligation to acknowledge patients' multiple identities and use the practice of cultural humility to provide individualized, patient-centered care.
Assuntos
Características Culturais , Neoplasias/psicologia , Neoplasias/terapia , Minorias Sexuais e de Gênero , Educação Continuada/organização & administração , Feminino , Acessibilidade aos Serviços de Saúde , Mão de Obra em Saúde , Humanos , Masculino , Neoplasias/epidemiologia , Neoplasias/enfermagem , Relações Enfermeiro-Paciente , Assistência Centrada no Paciente , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Significant research progress has been made in immunotherapies since the mid-1990s, and this rapid evolution necessitates evidence-based education on immunotherapies, their pathophysiology, and their toxicities to provide safe, effective care.â©. OBJECTIVES: The aim of this article is to provide an evidence-based overview, with implications for practice, of checkpoint inhibitors, monoclonal antibodies, oncolytic viral therapies, and chimeric antigen receptor T-cell therapies.â©. METHODS: Each immunotherapy category is presented according to the pathophysiology of its immune modulation, the classes of agents within each category, evidence-based toxicities associated with each class, and implications for practice.â©. FINDINGS: Immunotherapies vary in their pathophysiology and offer potential to be highly effective for the management of a wide array of cancer types. Understanding the unique pathophysiology and toxicities is necessary to assess, manage, and provide safe, effective patient-focused care.