Demand preferences for health management services in a population of older adults with visual impairment in China: a conjoint analysis.
Demand preferences for health management services in a population of older adults with visual impairment in China: a conjoint analysis.
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DOI：
10.1186/s12877-022-02957-0
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发表时间：
2022-03-26
期刊：
影响因子：
4.1
通讯作者：
Wang AP
中科院分区：
文献类型：
--
作者：
Li S;Wang AP
视力障碍严重影响老年人的生活质量。对老年VI患者制定适当的健康管理策略，有助于延缓疾病的发展和进展，提高生活质量。本研究旨在了解老年VI患者对健康管理服务的需求偏好，为制定该人群未来的健康管理策略提供参考。采用联合分析方法，分析老年VI患者对健康管理服务的需求偏好。通过文献分析，提取出11个关键词，经专家讨论，选取6个关键词作为健康管理策略的属性，并确定各属性的等级。然后通过正交设计将不同属性水平组合形成18种具有代表性的虚拟健康管理策略，并对VI老年人进行评分。本研究采用分层抽样的方法，选取2021年2月27日至2021年6月30日在中国医科大学附属第一医院和沈阳市第四人民医院眼科就诊的334例老年VI患者。在纳入的334人中，80人患有1级VI，80人患有2级VI，84人患有3级VI，90人患有4级VI。健康管理服务对老年VI患者的相对重要性依次为持续护理（24.033%）、视觉辅助应用（19.61%）、健康教育（16.241%）、预防保健（15.667%）、安全管理（12.757%）和康复训练（11.392%）。持续护理、安全管理和预防保健各层次的效用值均为正，而视觉辅助、健康教育和康复训练各层次的效用值均为负。健康管理服务的相对重要性和效用值在不同VI等级的老年人中存在差异。从整体上看，老年VI患者对继续护理的偏好较高，对康复训练的偏好较低。不同VI等级的老年人偏好不同，医务工作者可根据其不同的需求偏好制定相应的健康管理策略，进行分级健康管理。在健康管理策略中，应尽可能满足老年人偏好的服务，而对于偏好度较低的服务，则可探究原因，有针对性地进行改进，以满足老年人的需求偏好。
Visual impairment (VI) seriously affects the quality of life of the older adults. It is important to formulate appropriate health management strategies for the older adults with VI to help delay the disease development and progression, and improve life quality. The aim of this study was to understand the demand preference for health management services of the older adults with VI, and to provide a reference for the development of future health management strategies in this population. The conjoint analysis method was used to analyze demand preferences for health management services of the older adults with VI. 11 keywords were extracted after literature analyzed, 6 keywords were selected as the attributes of health management strategy after expert discussion and the level of each attribute was determined. Then 18 representative virtual health management strategies were formed by combination of different attribute levels through orthogonal design, and older adults with VI were asked to score. A total of 334 older adults with VI who attended the ophthalmology department of the First Affiliated Hospital of China Medical University and the Fourth People's Hospital of Shenyang from February 27, 2021 to June 30, 2021were enrolled in this study by stratified sampling. Of the 334 included people, 80 had grade 1 VI, 80 had grade 2 VI, 84 had grade 3 VI, and 90 had grade 4 VI. The relative importance of health management services ranked by older adults with VI was continuing care (24.033%), visual aid application (19.61%), health education (16.241%), preventive healthcare (15.667%), safety management (12.757%), and rehabilitation training (11.392%). The utility values of each level of continuing care, safety management and preventive healthcare were positive, whereas the utility values of each level of visual aid application, health education and rehabilitation training were negative. The relative importance and utility values of health management services were different for the older adults with different grades of VI. From the whole group, the older adults with VI have a higher preference for continuing care and a lower preference for rehabilitation training. The preference of the older adults with different grades of VI is different, so medical workers can formulate corresponding health management strategies according to their different demand preferences, and carry out hierarchical health management. Services that they preferred should be satisfied as much as possible in the health management strategy, while the reasons for the services with lower preference can be explored and make targeted improvement to meet the demand preferences of them.
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