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多学科团队会议的益处、障碍及看法:瑞典癌症护理领域的一项调查

Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care.

作者信息

Rosell Linn, Alexandersson Nathalie, Hagberg Oskar, Nilbert Mef

机构信息

Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Scheelev. 2, 223 63, Lund, Sweden.

Regional Cancer Centre South, Region Skåne, Sweden.

出版信息

BMC Health Serv Res. 2018 Apr 5;18(1):249. doi: 10.1186/s12913-018-2990-4.

Abstract

BACKGROUND

Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants' views on the meeting function, including perceived benefits and barriers.

METHODS

In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation.

RESULTS

The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports.

CONCLUSIONS

Health professionals' report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented.

摘要

背景

在多学科团队会议(MDTMs)上进行病例回顾和讨论已发展成为癌症护理的标准做法,目的是提供基于证据的治疗建议。作为优化多学科团队会议工作的基础,我们调查了参与者对会议功能的看法,包括感知到的益处和障碍。

方法

在一项横断面研究设计中,来自瑞典南部的244名卫生专业人员对多学科团队会议的结构和功能、这些会议的益处以及达成治疗建议的障碍进行了评分。

结果

多学科团队会议的首要优势是对患者管理的支持和能力发展。在监测患者是否纳入临床试验以及为改进多学科团队会议而进行的结构化工作方面评分较低。护士和癌症护理协调员参与病例讨论的报告频率低于医生。据报告,多学科团队会议的主要益处是更准确的治疗建议、多学科评估以及遵循临床指南。据报告,达成联合治疗建议的主要障碍是需要补充调查以及病理报告不足。

结论

卫生专业人员报告了多学科团队会议的多种益处,但也明确了需要改进的领域,例如获取完整信息以及明确不同卫生专业的角色。新出现的情况表明,应制定并实施定期进行多学科团队会议评估的架构,并更多地关注与患者相关的观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a09/5887214/7ca89fdfb5d5/12913_2018_2990_Fig1_HTML.jpg

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