Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.
Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Cancer. 2021 Jul 15;127(14):2579-2586. doi: 10.1002/cncr.33339. Epub 2020 Nov 25.
Interdisciplinary teamwork supports high-quality cancer care and effective utilization of limited resources. This study purposed to examine the value, structure, process, and effectiveness of interdisciplinary care (IDC) among pediatric oncology providers in low-income and middle-income countries in Central America and the Caribbean.
A cross-sectional survey was disseminated to pediatric oncology providers at 5 centers participating in the Pediatric Hematology-Oncology Association of Central America. The survey included previously validated items and novel questions assessing the value (importance), structure (multidisciplinary meeting attendance), process (team climate), and effectiveness (job satisfaction, quality of care and communication) of IDC.
The survey was completed by 174 providers, including 22 oncologists, 9 pathologists, 9 radiologists, 5 radiation oncologists, 12 surgeons, 35 subspecialists, 60 nurses, 20 psychosocial providers, and 2 other staff. Participants agreed that IDC benefits team members (95%) and patients (96%). IDC structure and processes varied across the region. Multidisciplinary meeting attendance differed by center (P = .005) and discipline (P < .0001). Participants who frequently attended multidisciplinary meetings reported a more positive team climate (P = .0003). Team climate was positively associated with job satisfaction (P < .001). In multivariable analyses, team climate was predictive of an improved perception of communication between professionals (P < .0001), with families (P < .0001), and with patients (P = .0005), as well as with quality of the care environment (P = .006) and overall care quality (P < .0001).
Nearly all surveyed participants valued IDC, and the structure and processes supporting IDC varied by center. Associations between a collaborative professional climate, job satisfaction, and the perception of quality care encourage continued investigation and prioritization of IDC in these settings.
跨学科团队合作支持高质量的癌症护理和有效利用有限的资源。本研究旨在检验中美洲和加勒比地区低收入和中等收入国家儿科肿瘤学提供者之间的跨学科护理（IDC）的价值、结构、过程和效果。
向参与中美洲儿科学会血液学-肿瘤学协会的 5 个中心的儿科肿瘤学提供者分发了一份横断面调查。该调查包括先前验证过的项目和新问题，评估 IDC 的价值（重要性）、结构（多学科会议出席情况）、过程（团队氛围）和效果（工作满意度、护理质量和沟通）。
共有 174 名提供者完成了调查，包括 22 名肿瘤学家、9 名病理学家、9 名放射科医生、5 名放射肿瘤学家、12 名外科医生、35 名专家、60 名护士、20 名心理社会提供者和 2 名其他工作人员。参与者一致认为 IDC 使团队成员（95%）和患者（96%）受益。该区域的 IDC 结构和流程存在差异。多学科会议出席情况因中心（P=0.005）和学科（P<0.0001）而异。经常参加多学科会议的参与者报告说团队氛围更为积极（P=0.0003）。团队氛围与工作满意度呈正相关（P<0.001）。在多变量分析中，团队氛围与专业人员之间（P<0.0001）、与家庭（P<0.0001）和与患者（P=0.0005）之间的沟通感知、护理环境质量（P=0.006）和整体护理质量（P<0.0001）的改善有关。
几乎所有接受调查的参与者都重视 IDC，支持 IDC 的结构和流程因中心而异。协作专业氛围、工作满意度和护理质量感知之间的关联鼓励在这些环境中继续对 IDC 进行调查和优先考虑。
