Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada.
Support Care Cancer. 2012 Aug;20(8):1771-7. doi: 10.1007/s00520-011-1274-x. Epub 2011 Sep 25.
The objectives of this study were: (1) to describe parents and health care professionals (HCPs) perceived importance of oral mucositis prevention in children with cancer; (2) To describe utilities and willingness-to-pay (WTP) to prevent mucositis.
Respondents included parents of children receiving intensive chemotherapy for leukemia/lymphoma or undergoing stem cell transplantation and HCPs caring for children with cancer. Importance of mild and severe oral mucositis was estimated using a visual analogue scale (VAS). Mucositis-associated utilities were elicited using the time trade-off technique (TTO). WTP to avoid mucositis was obtained using contingent valuation. These techniques quantify how much time or money the participant is willing to relinquish in order to prevent mucositis.
Eighty-two parents and 60 HCPs were included. Parents and HCPs believed mild mucositis to be of similar importance (median VAS 2.5 versus 3.6; P = 0.357) while parents considered severe mucositis less important than HCPs (median VAS 8.3 versus 9.0; P < 0.0001). No differences in parent versus HCP responses were seen with TTO (mild or severe mucositis) and most parents were not willing to trade any survival time to prevent severe mucositis. Parents were willing to pay significantly more than HCPs to prevent mild mucositis (average median WTP $1,371 CAN vs. $684 CAN, P = 0.031). No differences were seen in WTP to prevent severe mucositis.
Parents and HCP believe severe mucositis to be important, although it is more important to HCPs. Parents would not be willing to reduce life expectancy to eliminate mucositis.
本研究的目的是:(1)描述癌症患儿的父母和医护人员(HCP)对预防口腔黏膜炎的重要性的认知;(2)描述预防黏膜炎的效用和支付意愿(WTP)。
调查对象包括正在接受白血病/淋巴瘤强化化疗或进行干细胞移植的患儿父母以及照顾癌症患儿的 HCP。使用视觉模拟量表(VAS)评估轻度和重度口腔黏膜炎的重要性。使用时间权衡技术(TTO)得出与黏膜炎相关的效用。通过条件价值评估法获得避免黏膜炎的 WTP。这些技术可量化参与者为预防黏膜炎而愿意放弃多少时间或金钱。
共纳入 82 名患儿父母和 60 名 HCP。父母和 HCP 认为轻度黏膜炎的重要性相似(VAS 中位数分别为 2.5 和 3.6;P=0.357),而父母认为重度黏膜炎的重要性低于 HCP(VAS 中位数分别为 8.3 和 9.0;P<0.0001)。TTO 评估中,父母与 HCP 的回答没有差异(轻度或重度黏膜炎),且大多数父母不愿为预防重度黏膜炎而牺牲任何生存时间。父母预防轻度黏膜炎的支付意愿明显高于 HCP(平均中位 WTP 分别为 1371 加元和 684 加元,P=0.031)。预防重度黏膜炎的 WTP 没有差异。
父母和 HCP 认为重度黏膜炎很重要,尽管对 HCP 来说更重要。父母不愿意为了消除黏膜炎而减少预期寿命。