Horlait Melissa, Baes Saskia, Dhaene Sophie, Van Belle Simon, Leys Mark
Vrije Universiteit Brussel (VUB), Department of Public Health, Research Group Organisation, Policy and Social Inequalities in Health Care (OPIH), 1090 Brussels, Belgium,
AZ Sint-Elisabeth Ziekenhuis, Department of Oncology, 9620 Zottegem, Belgium.
J Multidiscip Healthc. 2019 Feb 21;12:159-167. doi: 10.2147/JMDH.S196660. eCollection 2019.
In current cancer care, multidisciplinary team meetings (MDTMs) aim at uniting care professionals from different disciplines to decide upon the best possible treatment plan for the patients based on the available scientific evidence. In Belgium, the multidisciplinary approach is mandatory and formally regulated since 2003. Current research indicates that MDTMs are not always truly multidisciplinary, ie, with a mix of medical as well as paramedical disciplines, and that the medical profession (physicians and medical specialists) tends to dominate the interaction in MDTMs. To ensure that MDTMs can benefit from their diverse membership to achieve their full potential, significant attention should be devoted to the multidisciplinary character of these meetings. The aim of this study is to explore and describe the multidisciplinary character in MDTMs and how it is actually shaped in practice in different Flemish medical oncology departments.
For this study, we carried out an observational comparative case study. We studied 59 multidisciplinary team meetings at inpatient medical oncology departments in five different Belgian hospitals (academic as well as general) and explored multidisciplinarity and how it is actually shaped in practice.
The study is unique in identifying and analyzing three distinct types of MDTMs. The analysis of the three types revealed an inconsistent and, at times, contradictory picture of multidisciplinary team meetings. The findings also align with previous studies arguing that MDTMs in oncology are typically driven by doctors, with limited input of nurses and other nonmedical staff in which decisions are argued on biomedical information and far less consideration of psychosocial aspects.
The concept of a MDTM should not merely be a group of care professionals who work essentially independently and occasionally liaise with one another. Yet, this study has shown a worryingly low awareness of the true character of multidisciplinarity, particularly among medical disciplines.
在当前的癌症护理中，多学科团队会议（MDTMs）旨在联合来自不同学科的护理专业人员，根据现有的科学证据为患者确定最佳治疗方案。在比利时，自2003年起多学科方法成为强制性要求并受到正式规范。当前研究表明，多学科团队会议并不总是真正具有多学科性，即并非医学和辅助医疗学科的混合，而且医学专业（医生和医学专家）在多学科团队会议的互动中往往占据主导地位。为确保多学科团队会议能够从其多元化成员中受益以充分发挥潜力，应高度重视这些会议的多学科性质。本研究的目的是探索和描述多学科团队会议中的多学科性质，以及它在弗拉芒不同医学肿瘤学部门的实际实践中是如何形成的。
对于本研究，我们进行了一项观察性比较案例研究。我们研究了比利时五家不同医院（学术医院和综合医院）住院医学肿瘤学部门的59次多学科团队会议，探讨了多学科性及其在实际实践中的形成方式。
该研究在识别和分析三种不同类型的多学科团队会议方面具有独特性。对这三种类型的分析揭示了多学科团队会议存在不一致且有时相互矛盾的情况。研究结果也与之前的研究一致，即肿瘤学中的多学科团队会议通常由医生主导，护士和其他非医务人员的参与有限，决策基于生物医学信息，而对社会心理方面的考虑则少得多。
多学科团队会议的概念不应仅仅是一群基本上独立工作且偶尔相互联络的护理专业人员。然而，本研究显示出对多学科性真正性质的认识低得令人担忧，尤其是在医学学科中。
