Ungar Wendy J, Hadioonzadeh Anahita, Najafzadeh Mehdi, Tsao Nicole W, Dell Sharon, Lynd Larry D
Program of Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
The Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
BMC Pulm Med. 2015 Nov 17;15:146. doi: 10.1186/s12890-015-0141-9.
The preferences of parents and children with asthma influence their ability to manage a child's asthma and achieve good control. Potential differences between parents and adolescents with respect to specific parameters of asthma control are not considered in clinical asthma guidelines. The objective was to measure and compare the preferences of parents and adolescents with asthma with regard to asthma control parameters using best worst scaling (BWS).
Fifty-two parents of children with asthma and 44 adolescents with asthma participated in a BWS study to quantify preferences regarding night-time symptoms, wheezing/chest tightening, changes in asthma medications, emergency visits and physical activity limitations. Conditional logit regression was used to determine each group's utility for each level of each asthma control parameter.
Parents displayed the strongest positive preference for the absence of night-time symptoms (β = 2.09, p < 0.00001) and the strongest negative preference for 10 emergency room visits per year (β = -2.15, p < 0.00001). Adolescents displayed the strongest positive preference for the absence of physical activity limitations (β = 2.17, p < 0.00001) and the strongest negative preference for ten physical activity limitations per month (β = -1.97). Both groups were least concerned with changes to medications.
Parents and adolescents placed different weights on the importance of asthma control parameters and each group displayed unique preferences. Understanding the relative importance placed on each parameter by parents and adolescents is essential for designing effective patient-focused disease management plans.
哮喘患儿家长和患儿自身的偏好会影响其对儿童哮喘的管理能力以及实现良好控制的能力。临床哮喘指南未考虑家长与青少年在哮喘控制特定参数方面的潜在差异。目的是使用最佳最差标度法（BWS）测量并比较哮喘患儿家长和青少年在哮喘控制参数方面的偏好。
52名哮喘患儿的家长和44名哮喘青少年参与了一项BWS研究，以量化他们在夜间症状、喘息/胸部发紧、哮喘药物变化、急诊就诊和身体活动受限方面的偏好。使用条件logit回归来确定每组对每个哮喘控制参数各水平的效用。
家长对无夜间症状表现出最强烈的积极偏好（β = 2.09，p < 0.00001），对每年10次急诊就诊表现出最强烈的消极偏好（β = -2.15，p < 0.00001）。青少年对无身体活动受限表现出最强烈的积极偏好（β = 2.17，p < 0.00001），对每月10次身体活动受限表现出最强烈的消极偏好（β = -1.97）。两组对药物变化的关注最少。
家长和青少年对哮喘控制参数重要性的权重不同，且每组都表现出独特的偏好。了解家长和青少年对每个参数的相对重要性对于设计有效的以患者为中心的疾病管理计划至关重要。
