J Healthc Qual. 2022;44(5):255-268. doi: 10.1097/JHQ.0000000000000354.
Coordination of quality care for the growing population of cancer survivors with comorbidities remains poorly understood, especially among health disparity populations who are more likely to have comorbidities at the time of cancer diagnosis. This systematic review synthesized the literature from 2000 to 2022 on team-based care for cancer survivors with comorbidities and assessed team-based care conceptualization, teamwork processes, and outcomes. Six databases were searched for original articles on adults with cancer and comorbidity, which defined care team composition and comparison group, and assessed clinical or teamwork processes or outcomes. We identified 1,821 articles of which 13 met the inclusion criteria. Most studies occurred during active cancer treatment and nine focused on depression management. Four studies focused on Hispanic or Black cancer survivors and one recruited rural residents. The conceptualization of team-based care varied across articles. Teamwork processes were not explicitly measured, but teamwork concepts such as communication and mental models were mentioned. Despite team-based care being a cornerstone of quality cancer care, studies that simultaneously assessed care delivery and outcomes for cancer and comorbidities were largely absent. Improving care coordination will be key to addressing disparities and promoting health equity for cancer survivors with comorbidities.
协调患有合并症的癌症幸存者的高质量护理仍然知之甚少，特别是在癌症诊断时更有可能患有合并症的健康差异人群中。本系统评价综合了 2000 年至 2022 年关于癌症合并症幸存者的基于团队的护理的文献，并评估了基于团队的护理概念化、团队合作过程和结果。六个数据库搜索了关于患有合并症的成年人的原始文章，这些文章定义了护理团队组成和对照组，并评估了临床或团队合作过程或结果。我们确定了 1821 篇文章，其中 13 篇符合纳入标准。大多数研究发生在癌症治疗的活跃期，其中 9 项侧重于抑郁症管理。四项研究侧重于西班牙裔或黑人癌症幸存者，一项研究招募了农村居民。基于团队的护理的概念化在不同的文章中有所不同。团队合作过程没有被明确测量，但提到了沟通和心理模型等团队合作概念。尽管团队合作是高质量癌症护理的基石，但很少有研究同时评估癌症和合并症的护理提供和结果。改善护理协调将是解决癌症合并症幸存者差异和促进健康公平的关键。
