Gidman Wendy, Elliott Rachel, Payne Katherine, Meakin George H, Moore Julia
School of Pharmacy and Pharmaceutical Science, University of Manchester, Manchester, UK.
Paediatr Anaesth. 2007 Nov;17(11):1043-52. doi: 10.1111/j.1460-9592.2007.02271.x.
Currently, there is little evidence relating to which attributes of pediatric daycase surgery are most important to parents; therefore, it is difficult for policy-makers in the UK to incorporate parents' preferences into pediatric daycase service provision. Additionally, few studies have considered anesthesiologists' preferences in this area. Parents and anesthesiologists' preferences for perioperative care of children undergoing daycase surgery may differ and this could affect levels of satisfaction with service provision. This study aimed to elicit and compare the relative importance of attributes of pediatric daycase surgery provision to parents and anesthesiologists using an established stated preference method, the discrete choice experiment. The attributes considered were: parental involvement in medical decision making; parental presence at induction of anaesthesia; quality of recovery from anaesthesia; staff attitude; postoperative pain and cost to the parents.
A postal questionnaire including a discrete choice experiment was sent to (a) parents whose children had been admitted to hospital under a surgical consultant (n = 280) and (b) anesthesiologists who are resident in the UK and are members of the Association of Paediatric Anaesthetists (n = 193).
All six attributes studied were statistically significant to both respondent groups, indicating that all attributes were important to respondents. The strength of anesthesiologists and parents' preferences was significantly different for all attributes other than parental presence at induction of anaesthesia.
Parents and anesthesiologists had a significantly different order of priorities for service attributes.
目前，关于小儿日间手术的哪些属性对家长最为重要，几乎没有相关证据；因此，英国的政策制定者很难将家长的偏好纳入小儿日间手术服务的提供中。此外，很少有研究考虑麻醉医生在这方面的偏好。家长和麻醉医生对接受日间手术的儿童围手术期护理的偏好可能不同，这可能会影响对服务提供的满意度。本研究旨在使用既定的陈述偏好方法——离散选择实验，引出并比较小儿日间手术提供的属性对家长和麻醉医生的相对重要性。所考虑的属性包括：家长参与医疗决策；家长在麻醉诱导时在场；麻醉恢复质量；工作人员态度；术后疼痛以及家长的费用。
向（a）其孩子在外科顾问医生安排下住院的家长（n = 280）和（b）居住在英国且是小儿麻醉医师协会成员的麻醉医生（n = 193）发送了一份包含离散选择实验的邮政问卷。
所研究的所有六个属性对两个应答组均具有统计学意义，表明所有属性对应答者都很重要。除了家长在麻醉诱导时在场这一属性外，麻醉医生和家长对所有其他属性的偏好强度存在显著差异。
家长和麻醉医生对服务属性的优先顺序有显著不同。
