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了解助产士在提供新生儿血斑筛查信息方面的偏好。

Understanding Midwives' Preferences for Providing Information About Newborn Bloodspot Screening.

作者信息

Wright Stuart James, Ulph Fiona, Lavender Tina, Dharni Nimarta, Payne Katherine

机构信息

Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care (SJW, KP).

Division of Psychology and Mental Health (FU, ND).

出版信息

MDM Policy Pract. 2018 Jan 18;3(1):2381468317746170. doi: 10.1177/2381468317746170. eCollection 2018 Jan-Jun.

Abstract

Understanding preferences for information provision in the context of health care service provision is challenging because of the number of potential attributes that may influence preferences. This study aimed to identify midwives' preferences for the process and outcomes of information provision in an expanded national newborn bloodspot screening program. A sample of practicing midwives completed a hybrid-stated preference survey including a conjoint analysis (CA) and discrete choice experiment to quantify preferences for the types of, and way in which, information should be provided in a newborn bloodspot screening program. Six conjoint analysis questions captured the impact of different types of information on parents' ability to make a decision, and 10 discrete choice experiment questions identified preferences for four process attributes (including parents' ability to make a decision). Midwives employed by the UK National Health Service (n = 134) completed the survey. All types of information content were perceived to improve parents' ability to make a decision except for the possibility of false-positive results. Late pregnancy was seen to be the best time to provide information, followed by day 3 postbirth. Information before 20 weeks of pregnancy was viewed as reducing parents' ability to make a decision. Midwives preferred information to be provided by an individual discussion and did not think parents should receive information on the Internet. A hybrid stated preference survey design identified that a wide variety of information should be provided to maximize parents' ability to make a decision ideally provided late in pregnancy or on day 3 postbirth.

摘要

由于可能影响偏好的潜在属性数量众多,了解在医疗服务提供背景下的信息提供偏好具有挑战性。本研究旨在确定助产士对国家扩大新生儿血斑筛查项目中信息提供过程和结果的偏好。一组执业助产士完成了一项混合陈述偏好调查,包括联合分析(CA)和离散选择实验,以量化新生儿血斑筛查项目中应提供的信息类型和方式的偏好。六个联合分析问题捕捉了不同类型信息对父母决策能力的影响,十个离散选择实验问题确定了对四个过程属性(包括父母的决策能力)的偏好。英国国民医疗服务体系雇佣的助产士(n = 134)完成了调查。除了假阳性结果的可能性外,所有类型的信息内容都被认为能提高父母的决策能力。妊娠晚期被视为提供信息的最佳时间,其次是产后第3天。妊娠20周前提供信息被认为会降低父母的决策能力。助产士更喜欢通过个人讨论提供信息,并且认为父母不应该在互联网上获取信息。一种混合陈述偏好调查设计表明,应提供各种各样的信息,以最大限度地提高父母的决策能力,理想情况下应在妊娠晚期或产后第3天提供。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/feb5/6125045/81c1934e001e/10.1177_2381468317746170-fig1.jpg

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