Vullings Isabelle, Pilli Luis, Russchen Marie-Julie C H, Labrie Nanon H M, Swait Joffre, Uysal-Bozkir Özgül, Wammes Joost, MacNeil Vroomen Janet L
Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, The Netherlands.
Patient. 2025 Sep 18. doi: 10.1007/s40271-025-00774-2.
The Netherlands reformed its long-term care policy to encourage older adults to age in place with the support of informal caregivers. It remains unclear whether the available care and support options align with the needs and preferences of older adults and caregivers. Discrete choice experiments (DCE) are increasingly used to identify individual preferences. This study describes the development of attributes (e.g., emotional support) and attribute levels (e.g., psychologist and case manager) for a DCE on aging-in-place preferences among older adults and informal caregivers in The Netherlands.
Semi-structured interviews were conducted with older adults and informal caregivers to identify key components for successful aging in place. Interviews were transcribed, and reflexive thematic analysis identified patterns that led to a list of attributes. Visuals of these attributes were created and presented to a new sample of informal caregivers and older adults in focus groups to rank attributes and define attribute levels.
Attributes identified through the interviews (N = 28) included housing, personal care, household tasks, transportation, social activities, digital skills, and help navigating the healthcare system. Focus groups (N = 35) found that older adults prioritized housing, while informal caregivers prioritized navigating the healthcare system. Transportation and digital skills were ranked as the least important and were excluded from the final list of attributes.
Our findings provide a detailed understanding of aging-in-place preferences of older adults and informal caregivers. These insights will inform a DCE to quantify preferences and provide evidence for policymakers. This study increases transparency about the process of attribute development and level selection, contributing to the quality of the final DCE study.
荷兰对其长期护理政策进行了改革，以鼓励老年人在非正式护理人员的支持下居家养老。目前尚不清楚现有的护理和支持选项是否符合老年人及护理人员的需求和偏好。离散选择实验（DCE）越来越多地用于确定个人偏好。本研究描述了荷兰老年人和非正式护理人员就地养老偏好的DCE中属性（如情感支持）和属性水平（如心理学家和个案经理）的制定过程。
对老年人和非正式护理人员进行了半结构化访谈，以确定成功居家养老的关键要素。访谈内容被转录，通过反思性主题分析确定了导致属性列表的模式。创建了这些属性的可视化展示，并在焦点小组中向新的非正式护理人员和老年人样本展示，以对属性进行排序并定义属性水平。
通过访谈确定的属性（N = 28）包括住房、个人护理、家务、交通、社交活动、数字技能以及医疗系统导航帮助。焦点小组（N = 35）发现，老年人将住房列为优先事项，而非正式护理人员则将医疗系统导航列为优先事项。交通和数字技能被列为最不重要的因素，并被排除在最终的属性列表之外。
我们的研究结果提供了对老年人和非正式护理人员就地养老偏好的详细理解。这些见解将为DCE提供信息，以量化偏好并为政策制定者提供证据。本研究提高了属性开发和水平选择过程的透明度，有助于提高最终DCE研究的质量。
