照顾者和工作人员对原住民及托雷斯海峡岛民儿童医疗服务提供特征的偏好：一项最佳-最差尺度研究。

Carer and staff preferences for characteristics of health services delivery for Aboriginal and Torres Strait Islander children: a best-worst scaling study.

作者信息

Chando Shingisai, Howell Martin, Nixon Janice, Sherriff Simone, Slater Kym, Smith Natalie, Stevenson Laura, Dickson Michelle, Jaure Allison, Craig Jonathan C, Eades Sandra J, Howard Kirsten

机构信息

Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; and Poche Centre for Indigenous Health, The University of Sydney, Sydney, NSW, Australia.

Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia; and Leeder Centre for Health Policy, Economics and Data, University of Sydney, Sydney, NSW, Australia.

出版信息

Aust J Prim Health. 2025 Jul;31. doi: 10.1071/PY25048.

DOI:10.1071/PY25048

PMID:40977210

Abstract

Background Prioritising the characteristics of health services delivery can guide improvements to the quality of care for Aboriginal and Torres Strait Islander children and their carers. The aim of this study was to estimate the relative importance of 20 health services delivery characteristics for Aboriginal and Torres Strait Islander children. Methods From May 2022 to November 2023, best-worst scaling surveys were distributed in person and online to carers of Aboriginal and Torres Strait Islander children and staff who work at health services used by Aboriginal and Torres Strait Islander children. Preference scores (0-1) were calculated using multinomial logit regression models. Interaction terms were added to a regression model to examine preference heterogeneity. Results A total of 109 surveys were completed. Most participants identified as Aboriginal and Torres Strait Islander (81%), and were aged ≥30years(77%), female (83%) and either worked or used health services at an Aboriginal Community Controlled Health Organisation (84%). For the combined sample of carers and staff, the most important attribute was 'Treatment options are explained, and the carer is involved in decisions about the child's care', followed by 'Clinical staff ask carer about their concerns for their child and respond to them' and 'Clinical staff provide carers with the skills to manage their child's health at home'. Conclusions Our study identified that communication characteristics related to shared decision-making and empowerment are considered the most important characteristics of health services delivery for Aboriginal and Torres Strait Islander children.

摘要

背景确定卫生服务提供的特征有助于改进对原住民及托雷斯海峡岛民儿童及其照顾者的护理质量。本研究旨在评估20项卫生服务提供特征对原住民及托雷斯海峡岛民儿童的相对重要性。方法 2022年5月至2023年11月，通过面对面和在线方式向原住民及托雷斯海峡岛民儿童的照顾者以及在原住民及托雷斯海峡岛民儿童使用的卫生服务机构工作的人员发放最佳-最差尺度调查。使用多项逻辑回归模型计算偏好得分（0-1）。在回归模型中添加交互项以检验偏好异质性。结果共完成109份调查。大多数参与者为原住民及托雷斯海峡岛民（81%），年龄≥30岁（77%），女性（83%），且在原住民社区控制卫生组织工作或使用其卫生服务（84%）。对于照顾者和工作人员的综合样本，最重要的属性是“解释治疗方案并让照顾者参与有关儿童护理的决策”，其次是“临床工作人员询问照顾者对其孩子的担忧并做出回应”以及“临床工作人员向照顾者提供在家管理孩子健康的技能”。结论我们的研究表明，与共同决策和赋权相关的沟通特征被认为是原住民及托雷斯海峡岛民儿童卫生服务提供的最重要特征。