Department of Health Sciences, University of York, York, UK.
Stirling Management School, University of Stirling, Stirling, UK.
Health Serv Res. 2022 Feb;57(1):91-101. doi: 10.1111/1475-6773.13635. Epub 2021 Feb 25.
To identify and assess the preferences of people with long-term health conditions toward generalizable characteristics of self-management support interventions, with the objective to inform the design of more person-centered support services.
Primary qualitative and quantitative data collected on a representative sample of individuals with at least one of the fifteen most prevalent long-term conditions in the UK.
Targeted literature review followed by a series of one-to-one qualitative semistructured interviews and a large-scale discrete choice experiment.
Digital recording of one-to-one qualitative interviews, one-to-one cognitive interviews, and a series of online quantitative surveys, including two best-worst scaling and one discrete choice experiment, with individuals with long-term conditions.
On average, patients preferred a self-management support intervention that (a) discusses the options available to the patient and make her choose, (b) is individual-based, (c) face to face (d) with doctor or nurse, (e) at the GP practice, (f) sessions shorter than 1 hour, and (g) occurring annually for two-third of the sample and monthly for the rest. We found heterogeneity in preferences via three latent classes, with class sizes of 41% (C1), 30% (C2), and 29% (C3). The individuals' gender [P < 0.05(C1), P < 0.01(C3)], age [P < 0.05(C1), P < 0.05(C2)], type of long-term condition [P < 0.05(C1), P < 0.01(C3)], and presence of comorbidity [P < 0.01(C1), P < 0.01(C3), P < 0.01(C3)] were able to characterize differences between these latent classes and help understand the heterogeneity of preferences toward the above mentioned features of self-management support interventions. These findings were then used to profile individuals into different preference groups, for each of whom the most desirable form of self-management support, one that was more likely to be adopted by the recipient, could be designed.
We identified several factors that could be used to inform a more nuanced self-management support service design and provision that take into account the recipient's characteristics and preferences.
确定并评估患有长期健康状况的人群对自我管理支持干预措施的可推广特征的偏好，旨在为更以患者为中心的支持服务设计提供信息。
在英国最常见的 15 种长期疾病之一的代表性样本中收集的主要定性和定量数据。
针对文献进行综述，然后进行一系列一对一的定性半结构化访谈和大规模离散选择实验。
对患有长期疾病的个体进行一对一的定性访谈、一对一的认知访谈以及一系列在线定量调查的数字记录，包括两项最佳最差标度和一项离散选择实验。
平均而言，患者更喜欢以下自我管理支持干预措施：(a) 讨论患者可选择的方案并让她做出选择，(b) 基于个体，(c) 面对面（d）与医生或护士，(e) 在全科医生诊所，(f) 每次就诊时间少于 1 小时，(g) 三分之二的样本每年进行一次，其余的每月进行一次。我们通过三个潜在类别发现了偏好的异质性，类别大小分别为 41%（C1）、30%（C2）和 29%（C3）。个体的性别[P<0.05(C1)，P<0.01(C3)]、年龄[P<0.05(C1)，P<0.05(C2)]、长期疾病类型[P<0.05(C1)，P<0.01(C3)]和合并症的存在[P<0.01(C1)，P<0.01(C3)，P<0.01(C3)]能够描述这些潜在类别之间的差异，并有助于理解对自我管理支持干预措施上述特征的偏好异质性。然后，这些发现被用于为不同的偏好群体对个体进行分析，为每位患者设计最理想的自我管理支持形式，这种形式更有可能被患者接受。
我们确定了一些因素，可以用来为更细致入微的自我管理支持服务设计和提供提供信息，这些因素考虑到了接受者的特征和偏好。
