Catalan Cancer Plan, Hospital Duran i Reynals, 199-203 Avenue Gran Via de l'Hospitalet, Hospitalet de Llobregat 08908, Spain.
BMC Public Health. 2011 Feb 28;11:141. doi: 10.1186/1471-2458-11-141.
The Spanish National Health System recognised multidisciplinary care as a health priority in 2006, when a national strategy for promoting quality in cancer care was first published. This institutional effort is being implemented on a co-operative basis within the context of Spain's decentralised health care system, so a high degree of variability is to be expected. This study was aimed to explore the views of professionals working with multidisciplinary cancer teams and identify which barriers to effective team work should be considered to ensure implementation of health policy.
Qualitative interview study with semi-structured, one-to-one interviews. Data were examined inductively, using content analysis to generate categories and an explanatory framework. 39 professionals performing their tasks, wholly or in part, in different multidisciplinary cancer teams were interviewed. The breakdown of participants' medical specialisations was as follows: medical oncologists (n = 10); radiation oncologists (n = 8); surgeons (n = 7); pathologists or radiologists (n = 6); oncology nurses (n = 5); and others (n = 3).
Teams could be classified into three models of professional co-operation in multidisciplinary cancer care, namely, advisory committee, formal co-adaptation and integrated care process. The following barriers to implementation were posed: existence of different gateways for the same patient profile; variability in development and use of clinical protocols and guidelines; role of the hospital executive board; outcomes assessment; and the recording and documenting of clinical decisions in a multidisciplinary team setting. All these play a key role in the development of cancer teams and their ability to improve quality of care.
Cancer team development results from an specific adaptation to the hospital environment. Nevertheless, health policy plays an important role in promoting an organisational approach that changes the way in which professionals develop their clinical practice.
2006 年，西班牙国家卫生系统将多学科护理确认为优先卫生事项，当时首次发布了促进癌症护理质量的国家战略。这项机构工作是在西班牙分散式医疗保健系统的合作框架内实施的，因此可以预期会有高度的可变性。本研究旨在探讨与多学科癌症团队合作的专业人员的观点，并确定应考虑哪些障碍以确保有效团队合作，从而确保卫生政策的实施。
采用半结构式一对一访谈的定性访谈研究。使用内容分析对数据进行归纳分析，以生成类别和解释框架。共采访了 39 名在不同多学科癌症团队中全职或部分从事任务的专业人员。参与者的医学专业分类如下：肿瘤内科医生（n=10）；放射肿瘤学家（n=8）；外科医生（n=7）；病理学家或放射科医生（n=6）；肿瘤护士（n=5）；和其他（n=3）。
可以将团队分为多学科癌症护理中三种专业合作模式，即咨询委员会、正式共同适应和综合护理流程。实施面临以下障碍：同一患者群体存在不同的入口；临床方案和指南的制定和使用存在差异；医院执行委员会的作用；结果评估；以及在多学科团队环境中记录和记录临床决策。所有这些在癌症团队的发展及其提高护理质量的能力方面都起着关键作用。
癌症团队的发展是对医院环境的特定适应。然而，卫生政策在促进组织方法方面发挥着重要作用，这种方法改变了专业人员开展临床实践的方式。
