Pradelli Lucia, Risoli Camilla, Summer Elena, Bellini Giulia, Mozzarelli Fabio, Anderson Gloria, Guasconi Massimo, Artioli Giovanna, Bonacaro Antonio, Sarli Leopoldo
Azienda USL di Piacenza, Piacenza, Italy.
Fondazione Madonna della Bomba Scalabrini ETS, Piacenza, Italy.
BMJ Open. 2025 Mar 21;15(3):e087268. doi: 10.1136/bmjopen-2024-087268.
A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings.
A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski .
Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024.
Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme.
The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden.
Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context.
This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings.
CRD42022297395.
多学科团队对于提供高质量的以患者为中心的护理至关重要。然而，其有效性可能会受到各种因素的阻碍或促进，例如快速决策的需求，尽管个人做出了努力，但这可能会影响患者的治疗结果。本研究的目的是综合可能成为多学科团队在急性护理环境中管理分娩工作的障碍和促进因素。
按照桑德洛维茨提出的五步方法进行了系统的定性综述和元综合分析。
对三个数据库（Medline、Embase和Scopus）进行了系统检索，检索时间截至2024年5月25日，无时间限制。
纳入探索观点、经验和其他类似因素的定性研究。使用批判性评估技能计划对这些研究的方法质量进行评估。
评审人员独立检索、筛选并对纳入研究的结果进行编码。使用托马斯和哈登提出的方法对数据进行综合。
元综合分析纳入了17项研究。出现了四个关键维度，反映了多学科团队绩效的障碍和促进因素：（1）组织变量，（2）个体变量，（3）协作变量和（4）角色变量。共识别出36个变量，根据具体情况，这些变量可能充当障碍（n = 6；例如，员工流动率高）、促进因素（n = 6；例如，强大的倾听技巧）或两者兼具（n = 24；例如，团队氛围）。
这项元综合分析确定了特定的障碍、促进因素以及兼具两者作用的变量。了解这些因素有助于进行有针对性的干预，以提高多学科团队在临床实践中的绩效，特别是在急性护理环境中。
PROSPERO注册号：CRD42022297395。
