国内外医疗团队合作评估工具系统综述

Domestic and International Assessment Tools for Medical Teamwork:a Systematic Review

背景近年来“以健康为中心”理念的推广及患者医疗保健需求的不断增加,对医疗保健提供者提出了更高的要求。组建高效的医疗合作团队被视为提升医疗服务质量的重要手段,选择客观、有效的团队合作评估工具对于团队成员间合作状况的评估及团队建设尤为重要。目的对国内外医疗团队合作评估工具进行系统梳理,为根据不同情况合理选择医疗团队合作评估工具提供参考。方法于2022年4月检索PubMed、中国知网、万方数据知识服务平台、维普网2016年1月—2022年4月公开发表的医疗团队合作评估工具相关文献。由两名研究人员独立进行文献筛选及信息提取,并交叉核对。应用中文版健康测量工具的统一标准(COSMIN)研究设计清单对评估工具进行质量评价。结果共纳入30篇文献,涉及32个医疗团队合作评估工具,其中对于本土化版本工具同时纳入其原始版本工具,最终共纳入医疗团队合作评估工具49个。对纳入的30篇文献所涉及的32个医疗团队合作评估工具进行总体设计及方法学质量评价,结果显示:在量表的总体设计上,20个量表总体设计评价为“很好”,2个为“良好”,10个为“模糊”;内容效度方面,1个量表方法学质量为“很好”,12个为“良好”,19个为“模糊”;结构效度方面,19个量表方法学质量为“很好”,10个为“良好”,3个为“不良”;内部一致性方面,29个量表方法学质量为“很好”,1个为“良好”,2个为“模糊”;稳定性方面,6个量表方法学质量为“很好”,8个为“良好”,1个为“模糊”,其他量表未报告相关信息。根据团队成员专业背景的不同,可分为跨专业团队合作评估工具(43个)和专业内团队合作评估工具(6个)。跨专业团队合作评估工具按照职种的不同进一步分为医护团队评估工具(20个)和医生、护士、药剂师、治疗师、营养师等“多位一体”团队评估工具(23个)。结论医疗团队合作评估工具的研究日益受到国内外学者的重视,评估工具的内容较为丰富,但仍需进一步开发构建专门适用于基层医疗卫生机构的团队合作评估工具。

Background In recent years,the promotion of"health-centered"concept and the increasing demands for health care of patients have placed greater demands on healthcare providers.The establishment of effective health care team is regarded as an important approach to improve service quality.The selection of objective and valid teamwork assessment tools is particularly important for the assessment of cooperation status among team members and team building.Objective To perform a systematic review of domestic and international assessment tools for medical teamwork,in order to provide a reference for the rational selection of medical teamwork assessment tools according to different situations.Methods Pubmed,CNKI,Wanfang and VIP databases were searched in April 2022 for literature related to medical teamwork assessment tools from January 2016 to April 2022.Literature screening and information extraction were performed independently by two investigators and cross-checked.The Chinese version of COSMIN study design checklist was used to evaluate the quality of the assessment tools.Results A total of 30 articles were included,involving 32 medical teamwork assessment tools,localized versions of the tools were also included in their original versions of the tools,and a total of 49 medical teamwork assessment tools were finally included.The results of the overall design and methodological quality evaluation of 32 medical teamwork assessment tools covered by 30 included papers showed that in terms of the overall design of the tools,20 were considered as"very good",2 as"good",and 10 as"vague";in terms of the content validity,1 was considered as"very good",12 as"good",and 19 as"vague";in terms of the construct validity,19 were considered as"very good",10 as"good",and 3 as"poor";in terms of internal consistency,29 were considered as"very good",1 as"good",and 2 as"vague";in terms of stability,6 were considered as"very good",8 as"good",1 as"vague"and other relevant information was not reported.The assessment tools were divided into the interprofessional teamwork assessment tools(n=43)and intraprofessional teamwork assessment tools(n=6)based on the professional background of the team members.The interprofessional teamwork assessment tools were divided into the physician-nurse team assessment tools(n=20)and integration of multiple roles team assessment tools(n=23)including physicians,nurses,pharmacists,therapists,dietitians and others based on the job categories.Conclusion The research on the assessment tools of medical teamwork has received increasing attention from scholars at home and abroad.The content of the assessment tools is relatively rich,but further development is needed to construct a teamwork assessment tool specifically applicable to primary health care team.