Interdisciplinary care of pediatric oncology patients in Central America and the Caribbean.
child
developing countries
interdisciplinary communication
neoplasms
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 07 2021
15 07 2021
Historique:
revised:
12
10
2020
received:
31
08
2020
accepted:
27
10
2020
pubmed:
26
11
2020
medline:
8
3
2022
entrez:
25
11
2020
Statut:
ppublish
Résumé
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.
Sections du résumé
BACKGROUND
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2579-2586Subventions
Organisme : American Lebanese Syrian Associated Charities
Informations de copyright
© 2020 American Cancer Society.
Références
Ward ZJ, Yeh JM, Bhakta N, Frazier AL, Atun R. Estimating the total incidence of global childhood cancer: a simulation-based analysis. Lancet Oncol. 2019;20:483-493. doi:10.1016/S1470-2045(18)30909-4
Ward ZJ, Yeh JM, Bhakta N, Frazier AL, Girardi F, Atun R. Global childhood cancer survival estimates and priority-setting: a simulation-based analysis. Lancet Oncol. 2019;20:972-983. doi:10.1016/S1470-2045(19)30273-6
Rodriguez-Galindo C, Friedrich P, Alcasabas P, et al. Toward the cure of all children with cancer through collaborative efforts: pediatric oncology as a global challenge. J Clin Oncol. 2015;33:3065-3073. doi:10.1200/JCO.2014.60.6376
Bosch M, Faber MJ, Cruijsberg J, et al. Effectiveness of patient care teams and the role of clinical expertise and coordination a literature review. Med Care Res Rev. 2009;66(6 suppl):S5-S35. doi:10.1177/1077558709343295
Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol. 2006;7:935-943. doi:10.1016/S1470-2045(06)70940-8
Taylor C, Munro AJ, Glynne-Jones R, et al. Multidisciplinary team working in cancer: what is the evidence? BMJ. 2010;340:c951. doi:10.1136/BMJ.C951
West MA, Guthrie JP, Dawson JF, Borrill CS, Carter M. Reducing patient mortality in hospitals: the role of human resource management. J Organ Behav. 2006;27:983-1002. doi:10.1002/job.396
Tremblay D, Roberge D, Touati N, Maunsell E, Berbiche D. Effects of interdisciplinary teamwork on patient-reported experience of cancer care. BMC Health Serv Res. 2017;17:218. doi:10.1186/s12913-017-2166-7
Atun R, Bhakta N, Denburg A, et al. Sustainable care for children with cancer: a Lancet Oncology Commission. Lancet Oncol. 2020;21:e185-e224. doi:10.1016/S1470-2045(20)30022-X
Goss PE, Lee BL, Badovinac-Crnjevic T, et al. Planning cancer control in Latin America and the Caribbean. Lancet Oncol. 2013;14:391-436. doi:10.1016/S1470-2045(13)70048-2
Friedrich P, Ortiz R, Fuentes S, et al. Barriers to effective treatment of pediatric solid tumors in middle-income countries: can we make sense of the spectrum of nonbiologic factors that influence outcomes? Cancer. 2014;120:112-125. doi:10.1002/cncr.28339
Ayanian JZ, Chrischilles EA, Wallace RB, et al. Understanding cancer treatment and outcomes: the Cancer Care Outcomes Research and Surveillance Consortium. J Clin Oncol. 2004;22:2992-2996. doi:10.1200/JCO.2004.06.020
Sexton JB, Helmreich RL, Neilands TB, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006. doi:10.1186/1472-6963-6-44
Donabedian A. Evaluating the quality of medical care. 1966. Milbank Q. 2005;83:691-729. doi:10.1111/j.1468-0009.2005.00397.x
Ibraheem AF, Giurcanu M, Sowunmi AC, et al. Formal assessment of teamwork among cancer health care professionals in three large tertiary centers in Nigeria. JCO Glob Oncol. 2020;6:560-568. doi:10.1200/JGO.19.00233
Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49-61. doi:10.2147/JMDH.S117945
Harris J, Taylor C, Sevdalis N, Jalil R, Green JSA. Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT). Int J Qual Heal Care. 2016;28:332-338. doi:10.1093/intqhc/mzw030
Patkar V, Acosta D, Davidson T, Jones A, Fox J, Keshtgar M. Cancer multidisciplinary team meetings: evidence, challenges, and the role of clinical decision support technology. Int J Breast Cancer. 2011;2011:831605. doi:10.4061/2011/831605
Luna-Fineman S, Barnoya M, Bonilla M, Fu L, Baez F, Rodriguez-Galindo C. Retinoblastoma in Central America: report from the Central American Association of Pediatric Hematology Oncology (AHOPCA). Pediatr Blood Cancer. 2012;58:545-550. doi:10.1002/pbc.23307