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探索尿路上皮肿瘤多学科团队会议对患者结局的影响:一项系统评价。

Exploring the impact of uro-oncology multidisciplinary team meetings on patient outcomes: A systematic review.

机构信息

Faculty of Health, University of Canberra, Bruce, ACT, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT, Australia.

Faculty of Health, University of Canberra, Bruce, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT, Australia.

出版信息

Eur J Oncol Nurs. 2021 Oct;54:102032. doi: 10.1016/j.ejon.2021.102032. Epub 2021 Sep 16.

Abstract

PURPOSE

Multidisciplinary team (MDT) meetings are mainstay clinical management globally. Clinical guidelines state that patients should be considered for MDT review, but evidence has identified that within the specialty of uro-oncology not all patients are reviewed by an MDT. This systematic review aimed to understand the impact of uro-oncology MDT meetings on patient outcomes, to explore how patient engagement is incorporated in the process, and to identify the barriers and facilitators within an MDT.

METHODS

A systematic review was reported according to PRISMA guidelines. Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched in EBSCOhost from January 2010 to March 2021, using a range of key search words. Studies were assessed for inclusion according to a pre-defined eligibility criteria. Data extraction and quality assessment was undertaken. The findings were tabulated, and a narrative synthesis undertaken.

RESULTS

373 articles were screened, and seven studies were included. The studies were conducted in a range of international countries which provided an overview of uro-oncology MDTs in different healthcare contexts. The following themes were identified: 1) MDT and clinical outcomes, 2) structure and format, 3) patient engagement in the process, and 4) barriers and facilitators.

CONCLUSION

Cancer care is constantly being challenged due to complex newer therapies, including multimodality treatments, and newer emergent broader considerations such as, oncogeriatrics, genetic counselling, and survivorship issues which should have a central place for consideration in the MDT.

摘要

目的

多学科团队(MDT)会议是全球临床管理的主要方式。临床指南指出,应考虑对患者进行 MDT 审查,但有证据表明,在泌尿肿瘤学专业中,并非所有患者都由 MDT 进行审查。本系统评价旨在了解泌尿肿瘤学 MDT 会议对患者结局的影响,探讨如何在该过程中纳入患者的参与,并确定 MDT 内部的障碍和促进因素。

方法

根据 PRISMA 指南报告了一项系统评价。在 EBSCOhost 中使用一系列关键搜索词,在 MEDLINE、CINAHL 和 PsychINFO 电子数据库中进行了 2010 年 1 月至 2021 年 3 月的搜索。根据预先确定的纳入标准评估研究的纳入情况。进行了数据提取和质量评估。将结果制成表格,并进行了叙述性综合。

结果

筛选出 373 篇文章,纳入了 7 项研究。这些研究在不同的国际国家进行,提供了不同医疗保健背景下泌尿肿瘤学 MDT 的概述。确定了以下主题:1)MDT 和临床结局,2)结构和格式,3)患者在该过程中的参与,以及 4)障碍和促进因素。

结论

由于复杂的新疗法,包括多模式治疗以及新出现的更广泛的考虑因素,如肿瘤老年病学、遗传咨询和生存问题,癌症护理不断面临挑战,这些都应该在 MDT 中占据重要位置。

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