Hundley V, Ryan M, Graham W
Centre for Advanced Studies in Nursing, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, AB25 2AY, Scotland.
Birth. 2001 Dec;28(4):254-63. doi: 10.1046/j.1523-536x.2001.00254.x.
Recent government reports have recommended involving consumers in the planning of health services. Although satisfaction surveys have traditionally been used, they have several limitations. This paper describes a relatively new method of eliciting consumer preferences that allows respondents (women) to indicate the importance that they attribute to specific aspects of a service. The aim was to explore the feasibility of using a discrete choice experiment to assess the importance to women of different aspects of intrapartum care.
In this pilot study of 301 women at low obstetric risk, data were collected using an anonymous self-complete questionnaire given to each participant by the midwife at the booking visit.
The results of the regression model suggest that respondents prefer maternity units that offer greater continuity of caregiver, more methods of pain relief, continuous fetal heart rate monitoring, a homely appearance, routine involvement of medical staff, and greater involvement for the woman in the decision-making process. Although all attributes were important to women, they were not all of equal importance. For example, if continuity of caregiver were achieved at the expense of decreasing the availability of pain relief then women would be worse off.
The discrete choice experiment appears to be a useful tool in assessing the strength of women's preferences for different aspects of maternity care. Future research should include a qualitative approach to explore in greater depth the processes involved in shaping women's preferences.
近期政府报告建议让消费者参与医疗服务规划。虽然传统上一直使用满意度调查，但它们存在一些局限性。本文描述了一种相对较新的引出消费者偏好的方法，该方法允许受访者（女性）表明她们赋予某项服务特定方面的重要性。目的是探讨使用离散选择实验评估分娩期护理不同方面对女性的重要性的可行性。
在这项针对301名低产科风险女性的试点研究中，数据通过在预约就诊时由助产士分发给每位参与者的匿名自填问卷收集。
回归模型结果表明，受访者更喜欢提供更高护理连续性、更多疼痛缓解方法、持续胎心监护、温馨外观、医护人员常规参与以及女性在决策过程中有更大参与度的产科病房。虽然所有属性对女性都很重要，但它们的重要性并不都相同。例如，如果以减少疼痛缓解的可用性为代价来实现护理连续性，那么女性的情况会更糟。
离散选择实验似乎是评估女性对产科护理不同方面偏好强度的有用工具。未来的研究应包括一种定性方法，以更深入地探讨塑造女性偏好的过程。
