目的:有效的团队合作对于医疗保健中的患者安全至关重要。TeamSTEPPS团队合作感知问卷(T-TPQ)是评估团队合作感知的广泛使用的工具。T-TPQ已在多个国家/地区进行了改编和验证,可用于医院环境。这项研究旨在将T-TPQ翻译成法语并验证其在突尼斯医疗保健专业人员中使用。加强团队合作评估和患者安全举措。
方法:严格的过程确保了T-TPQ的文化和语言适应,包括回译,专家小组审查,和试点测试。来自凯鲁万四家医院的459名医疗保健专业人员,突尼斯参加了会议。验证性因子分析(CFA)将原始的五因素结构与基于探索性因子分析(EFA)的修订结构进行了比较。
结果:两种CFA模型都表现出良好的拟合,两者无显著差异(Δχ2=22.51,p=0.79)。由于其既定的理论基础,保留了原有的五因素结构。法国T-TPQ表现出强的内部一致性(α=0.9)。双向随机ICC显示所有五个维度(0.633-0.848)的测试-重测可靠性良好。
结论:应该承认一些局限性。使用问卷作为数据收集工具是报告偏见的来源,因为害怕被识别或出于“社会可取性”的原因。然而,这种社会愿望是微乎其微的,作为贝克等人。(2010)在仪器的开发过程中采取了缓解这种情况的措施。此外,为了评估态度和看法,自我报告的措施被认为更有效,而行为评估提倡客观措施。此外,参与者被告知没有好的或坏的答案,尽可能仔细回答的重要性,和保密性。此外,考虑到数据收集期,COVID-19大流行及其对招聘的潜在影响,数据收集,参与者的反应。尽管459的样本量符合进行验证性因子分析的推荐标准,正如Bentler和Chou(1987)和(Floyd和Widaman,1995),COVID-19大流行给招聘带来了挑战。增加的工作量和医疗保健专业人员的压力,加上医院和护理单位内的人员调动和研究限制,可能会阻碍实现更大的样本量。这些情况还需要调整数据收集方法,以确保安全和遵守大流行协议。这涉及将在线调查选项与纸质问卷相结合,并在个人数据收集过程中实施更严格的卫生措施。此外,大流行影响了团队合作的看法,因为显著地重新定义了医疗环境,由于患者数量激增,给专业人士带来巨大压力,人员短缺,以及照顾危重病人的情感负担。这种增加的压力和工作量可能会影响团队合作动态,可能促进两种积极的适应,例如增加凝聚力和支持,以及沟通中断和士气下降等负面后果(Terregino等人。,2023年)。
结论:我们概述了对医疗保健领导者改善团队合作和患者安全的重要实际意义。或者,通过将经过验证的法国T-TPQ纳入其改进策略,医疗保健领导者可以显着增强团队合作和患者安全。这一可靠的工具能够评估工作人员对团队合作优势和劣势的看法,特别是在沟通和领导等领域。通过确定这些关键领域,领导者可以实施有针对性的培训计划和干预措施。事实上,现有的研究机构一致证明了团队培训干预措施的积极影响,团队合作过程和患者结果。这些干预措施已被证明可以提高团队合作技能(Baker等人。,2010年;托马斯和加拉,2013;Weaver等人。,2014).在通信等领域,领导力,形势监测,相互支持,导致死亡率和发病率下降(Weaver等人。,2014).实施团队培训计划促进围绕共同目标的信任和协作,为患者和专业人士提供更有效和更安全的医疗环境。此外,适应文化的T-TPQ不仅有利于个人医疗机构,而且还为全球范围内更广泛的研究和合作提供了机会。通过实现跨文化比较和基准,T-TPQ可以加深我们对团队合作动态如何在不同的医疗保健环境和文化背景下变化的理解。这些知识对于针对特定人群和环境定制团队合作干预和培训计划非常宝贵。确保其有效性和文化相关性。此外,将团队合作培训整合到持续的专业发展中,跨专业和医学教育计划对于培养协作能力和建立高性能的医疗团队至关重要。研究表明,跨专业团队合作经验显着增强护理和医学生的协作能力,强调在医疗保健教育早期纳入团队合作培训的重要性。这种方法为未来的医疗保健专业人员提供了驾驭复杂团队环境的必要技能,最终提高患者护理质量,减轻导致倦怠的工作量问题(Simin等人。,2010年;塞兰,2017年;福克斯等人。,2018)。
结论:与英语版本相比,T-TPQ的法语版本在语义上是等效的,在文化上具有足够的重测可靠性,扩大其适用性,并有助于理解这种背景下的团队合作观念。法国T-TPQ为评估团队合作提供了宝贵的工具,确定需要改进的地方,并实施干预措施,以加强突尼斯和其他可能的法语地区的团队合作和患者安全。
OBJECTIVE: Effective teamwork is crucial for patient safety in healthcare. The TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) is a widely used tool for assessing teamwork perceptions. The T-TPQ has been adapted and validated for hospital setting use in several countries. This study aimed to translate and validate the T-TPQ into French for use among Tunisian healthcare professionals, enhancing teamwork assessment and patient safety initiatives.
METHODS: A rigorous process ensured cultural and linguistic adaptation of the T-TPQ, including back-translation, expert panel review, and pilot testing. 459 healthcare professionals from four hospitals in Kairouan, Tunisia participated. Confirmatory factor analysis (
CFA) compared the original five-factor structure with a revised structure based on exploratory factor analysis (EFA).
RESULTS: Both
CFA models demonstrated good fit, with no significant difference between them (∆χ2 = 22.51, p = 0.79). The original five-factor structure was retained due to its established theoretical foundation. The French T-TPQ exhibited strong internal consistency (α = 0.9). Two-way Random ICCs indicated fair to good test-retest reliability for all the five dimensions (0.633-0.848).
CONCLUSIONS: Several limitations should be acknowledged. The use of a questionnaire as a data collection tool is the source of a reporting bias, for fear of being identified or for reasons of \"social desirability\". Nevertheless, this social desirability was minimal, as Baker et al. (2010) took steps to mitigate this during the instrument\'s development. Additionally, for assessing attitudes and perceptions, self-reported measures are deemed more effective, whereas objective measures are advocated for behavioral assessments. Furthermore, the participants were informed of the absence of good or bad answers, the importance of answering as closely as possible, and the confidentiality. Moreover, considering the data collection period, the COVID- 19 pandemic and its potential impact on recruitment, data collection, and participant responses. Although the sample size of 459 met the recommended criteria for conducting confirmatory factor analysis, as suggested by Bentler and Chou (1987) and (Floyd and Widaman, 1995), the COVID-19 pandemic presented challenges in recruitment. The increased workload and stress on healthcare professionals, coupled with staff redeployment and research restrictions within hospitals and care units, likely hindered achieving an even larger sample size. These circumstances also necessitated adjustments to data collection methods to ensure safety and adherence to pandemic protocols. This involved incorporating online surveys option with paper-based questionnaires and implementing stricter hygiene measures during in person data collection. Furthermore, the pandemic impacted the teamwork perceptions as significantly redefined the healthcare environment, placing immense pressure on professionals due to surging patient volumes, staff shortages, and the emotional burden of caring for critically ill individuals. This heightened stress and workload likely influenced teamwork dynamics, potentially fostering both positive adaptations, such as increased cohesion and support, as well as negative consequences like communication breakdowns and decreased morale (Terregino et al., 2023).
CONCLUSIONS: We outline significant practical implications for leaders in health care for improving teamwork and patient safety. Or, healthcare leaders can significantly enhance teamwork and patient safety by incorporating the validated French T-TPQ into their improvement strategies. This reliable tool enables the assessment of staff perceptions regarding teamwork strengths and weaknesses, specifically in areas like communication and leadership. By identifying these crucial areas, leaders can implement targeted training programs and interventions. In fact, the existing body of research consistently demonstrates the positive impact of team training interventions, on both teamwork processes and patient outcomes. These interventions have been shown to enhance teamwork skills (Baker et al., 2010; Thomas and Galla, 2013; Weaver et al., 2014). In areas such as communication, leadership, situation monitoring, and mutual support, leading to decreased mortality and morbidity rates (Weaver et al., 2014). Implementing team training programs fosters trust and collaboration around shared goals, contributing to a more effective and safer healthcare environment for both patients and professionals. Additionally, the culturally adapted T-TPQ not only benefits individual healthcare settings but also unlocks opportunities for broader research and collaboration on a global scale. By enabling cross-cultural comparisons and benchmarking, the T-TPQ can deepen our understanding of how teamwork dynamics vary across diverse healthcare environments and cultural contexts. This knowledge is invaluable for tailoring teamwork interventions and training programs to specific populations and settings, ensuring their effectiveness and cultural relevance. Moreover, integrating teamwork training into continuing professional development, interprofessional and medical education initiatives is crucial for cultivating collaborative competencies and building high-performing healthcare teams. Research has shown that interprofessional teamwork experiences significantly enhance collaborative competencies among nursing and medical students, emphasizing the importance of incorporating teamwork training early in healthcare education. This approach equips future healthcare professionals with the necessary skills to navigate complex team environments, ultimately improving patient care quality and mitigating workload issues that contribute to burnout (Simin et al., 2010; Ceylan, 2017; Fox et al., 2018).
CONCLUSIONS: The French version of the T-TPQ was semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English version, expanding its applicability and contributing to understanding teamwork perceptions in this context. The French T-TPQ offers a valuable tool for assessing teamwork, identifying areas for improvement, and implementing interventions to enhance teamwork and patient safety in Tunisia and potentially other French-speaking regions.