基于TEAM准则的我国肿瘤多学科诊疗模式有效性评估工具开发与应用  

Development and Application of an Evaluation Tool for the Effectiveness of Multidisciplinary Diagnosis and Treatment Mode for Cancer in China Based on the TEAM Criteria

作　　者：毛一晴 MAO Yiqing(The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou,Henan,450008,China)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院,河南郑州450008 [2]郑州大学公共卫生学院,河南郑州450001 [3]河南省医院管理研究院,河南郑州450000

出　　处：《中国卫生质量管理》2025年第4期46-52,共7页Chinese Health Quality Management

基　　金：国家自然科学基金项目——基于心理场论视角的肿瘤多学科诊疗行为激励机制研究(编号:72204226);河南省医学科技攻关计划项目——基于价值理论的肿瘤多学科诊疗旅程质量评价及优化研究(编号:RKX202302010)。

摘　　要：目的基于英国国家癌症行动小组提出的TEAM准则,开发适用于我国的肿瘤多学科诊疗(MDT)模式有效性评估工具并进行应用,为肿瘤MDT模式可持续发展提供参考。方法采用文献分析法,经研究小组讨论初步构建评估条目,通过两轮专家咨询确定评估内容,并进行信效度检验。对33个肿瘤MDT团队的491名成员开展问卷调查,了解MDT模式有效性现状。结果评估工具包括一级维度5个、二级维度17个、三级评价条目36个。评估工具效标效度r值均>0.80(P<0.05),结构效度KMO值为0.849(P<0.001),内部一致性Cronbach’sα系数为0.920。65.6%的MDT成员认为肿瘤MDT模式有效性处于中等水平,一级维度中团队组成(59.5%)、会议组织(73.3%)、以患者为中心的临床决策(63.1%)和二级维度中会议后期(56.2%)、以患者为中心的照护(58.1%)等有效性处于中低水平。结论构建的肿瘤MDT模式有效性评估工具具有创新性和可行性。应进一步完善制度和标准,加强成本效益分析,关注群体决策行为,规范质控体系,深化“以患者为中心”的服务内涵。Objective To develop and apply an evaluation tool tailored to China's context for assessing the effectiveness of multidisciplinary diagnosis and treatment(MDT)model for cancer based on the TEAM criteria proposed by the UK's National Cancer Action Team,providing reference for the sustainable development of the MDT model for cancer.Methods A literature review was conducted,and initial evaluation items were constructed through discussions among a research panel.The content of the evaluation was finalized through two rounds of expert consultations,followed by reliability and validity testing.A questionnaire survey was administered to 491 members from 33 MDT teams for cancer to understand the current status of MDT model effectiveness.Results The evaluation tool comprises 5 primary dimensions,17 secondary dimensions,and 36 tertiary items.The criterion-related validity r-values of the evaluation tool were all>0.80(P<0.05),the structural validity KMO value was 0.849(P<0.001),and the internal consistency Cronbach’sαcoefficient was 0.920.According to 65.6%of MDT members,the effectiveness of the MDT model for cancer was at a moderate level.Within the primary dimensions,team composition(59.5%),meeting organization(73.3%),and patient-centered clinical decision-making(63.1%)were rated as moderately to low effective,while within the secondary dimensions,post-meeting follow-up(56.2%)and patient-centered care(58.1%)were rated as moderately to low effective.Conclusion The developed evaluation tool for assessing the effectiveness of MDT model for cancer is innovative and feasible.It is necessary to further improve systems and standards,strengthen cost-benefit analysis,focus on group decision-making behaviors,standardize quality control systems,and deepen the connotation of"patient-centered"services.

关 键 词：肿瘤 多学科诊疗 有效性评估 TEAM准则 

分 类 号：R197.323[医药卫生—卫生事业管理] R73[医药卫生—公共卫生与预防医学]