Clin J Oncol Nurs. 2021 Oct 01;25(5):17-24. doi: 10.1188/21.CJON.S1.17-24.
Health Disparities: Impact of Health Disparities and Treatment Decision-Making Biases on Cancer Adverse Effects Among Black Cancer Survivors.
Clinical journal of oncology nursing
Jacqueline B Vo, Arielle Gillman, Kelsey Mitchell, Timiya S Nolan
Affiliations
Affiliations
- National Cancer Institute.
- University of Alabama at Birmingham Hospital.
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
PMID: 34533532
PMCID: PMC8544127 DOI: 10.1188/21.CJON.S1.17-24
Abstract
BACKGROUND: Health disparities affect cancer incidence, treatment decisions, and adverse effects. Oncology providers may hold biases in the decision-making process, which can perpetuate health disparities.
OBJECTIVES: The purpose of this article is to describe health disparities across treatment decisions and adverse effects, describe decision-making biases, and provide suggestions for nurses to mitigate adverse outcomes.
METHODS: A scoping review of the literature was conducted.
FINDINGS: Factors affecting health disparities stem, in part, from structural racism and decision-making biases, such as implicit bias, which occurs when individuals have unconscious negative thoughts or feelings toward a particular group. Other decision-making biases, seemingly unrelated to race, include default bias, delay discounting bias, and availability bias. Nurses and nurse navigators can mitigate health disparities by providing culturally appropriate care, assessing health literacy, providing education regarding adverse effects, serving as patient advocates, empowering patients, evaluating personal level of disease knowledge, and monitoring and managing cancer treatment adverse effects.
Keywords: cancer survivorship; decision bias; decision-making; treatment adverse effects
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