Zha Huixian, Mao Wenjun, Jiang Ling, Yan Hongyun, Guo Hua, Li Xianwen, Tian Xingyue
Nanjing Medical University Affiliated Suzhou Hospital, Suzhou, China.
Nanjing Medical University, Nanjing, Jiangsu, China
BMJ Open. 2025 May 22;15(5):e097257. doi: 10.1136/bmjopen-2024-097257.
Stroke is a leading cause of disability among older adults worldwide, often resulting in significant physical, cognitive and emotional impairments that require long-term care. With ageing populations and increasing stroke prevalence, the demand for appropriate and sustainable long-term care is growing. However, designing care models that align with the complex needs and preferences of elderly patients who had a stroke remains a challenge. This study employs a discrete choice experiment (DCE) to measure and quantify patients' preferences for long-term care. The primary objectives of this study are as follows: (1) identify and examine the key attributes and levels of long-term care that are most valued by this patient population, (2) assess patients' preferences for long-term care and explore the role of each attribute on overall preference and (3) explore heterogeneity in preferences based on participants' characteristics through subgroup analyses.
The research was conducted in accordance with the design programme of the DCE study. Seven attributes were developed through a systematic literature review, in-depth interviews and experts consultation. A partial factorial survey design was generated through an orthogonal experimental design to optimise the choice scenario sets. We plan to conduct a DCE questionnaire survey in Suzhou, Jiangsu Province, China, and recruit at least 500 participants. The final data will be analysed through a mixed logit model and a latent class model to explore the preference of elderly patients who had a stroke with disabilities for long-term care.
This study was approved by the Ethics Committee of Nanjing Medical University-Affiliated Suzhou Hospital (K-2024-096 K01). All participants will be required to provide informed consent. The findings of this study will be disseminated and shared with interested patient groups and the general public through a variety of channels, including online blogs, policy briefs, national and international conferences, and peer-reviewed journals.
中风是全球老年人残疾的主要原因,常常导致严重的身体、认知和情感障碍,需要长期护理。随着人口老龄化和中风患病率的上升,对适当且可持续的长期护理的需求不断增长。然而,设计出符合中风老年患者复杂需求和偏好的护理模式仍然是一项挑战。本研究采用离散选择实验(DCE)来测量和量化患者对长期护理的偏好。本研究的主要目标如下:(1)识别并检验该患者群体最看重的长期护理关键属性和水平;(2)评估患者对长期护理的偏好,并探究每个属性对总体偏好的作用;(3)通过亚组分析探索基于参与者特征的偏好异质性。
本研究按照DCE研究的设计方案进行。通过系统的文献综述、深入访谈和专家咨询确定了七个属性。通过正交实验设计生成部分因子调查设计,以优化选择情景集。我们计划在中国江苏省苏州市进行DCE问卷调查,并招募至少500名参与者。最终数据将通过混合逻辑模型和潜在类别模型进行分析,以探究中风残疾老年患者对长期护理的偏好。
本研究已获得南京医科大学附属苏州医院伦理委员会批准(K-2024-096 K01)。所有参与者均需提供知情同意书。本研究结果将通过多种渠道传播并分享给感兴趣的患者群体和公众,包括在线博客、政策简报、国内和国际会议以及同行评审期刊。