Using Best-Worst Scaling to Measure Caregiver Preferences for Managing their Child's ADHD: A Pilot Study
Using Best-Worst Scaling to Measure Caregiver Preferences for Managing their Child's ADHD: A Pilot Study
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DOI：
10.1007/s40271-014-0098-4
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发表时间：
2015-10-01
影响因子：
3.6
通讯作者：
Bridges, John F. P.
中科院分区：
文献类型：
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作者：
dosReis, Susan;Ng, Xinyi;Bridges, John F. P.
注意缺陷/多动障碍（ADHD）的管理是照顾者对益处的关注与循证治疗的风险之间的权衡。很少有研究使用基于选择的方法来评估对护理人员最重要的治疗属性。目的是开发和试验一种工具，以引出照顾者对其孩子多动症的循证管理的偏好。采用混合方法开发最佳最差标度（Best-Worst Scaling， BWS）仪器，并采用定量方法对该仪器进行试制。从两个社区组织招募ADHD儿童的主要照顾者进行发展阶段（n = 21）和试点阶段（n = 37）。该工具是一个BWS案例2，其中一次呈现18个管理概况，受访者指出每个概况的一个最佳和一个最差特征。采用主效应正交阵列设计了剖面。估计最佳-最差得分的平均值，属性重要性基于每个属性的最大-最小得分之和。用t检验和95%的置信区间评估诱发陈述偏好的可行性。七个属性（药物，治疗，学校，护理人员培训，提供者专业，提供者沟通和自付费用）每三个层次被确定。除儿科医生对儿童多动症的管理外，所有平均得分均显著（p = 0.089）。护理人员培训的相对重要性最高，其次是药物治疗和提供者沟通。BWS量表是一种相对简单的测量方法，照顾者独立完成，它区分了不同属性在儿童ADHD管理中的相对重要性。
Management of attention-deficit/hyperactivity disorder (ADHD) is a trade-off between caregivers' concerns about the benefits versus the risks of evidence-based treatment. Few studies have used choice-based methods to assess what treatment attributes matter most to caregivers.The aim was to develop and to pilot an instrument to elicit caregivers' preferences for evidence-based management of their child's ADHD.Mixed methods were used to develop a Best-Worst Scaling (BWS) instrument, and quantitative methods were used to pilot the instrument. Primary caregivers of children with ADHD from two community organizations were recruited for the development (n = 21) and pilot (n = 37) phase. The instrument was a BWS case 2, where 18 management profiles are presented one at a time, with respondents indicating the one best and one worst feature of each profile. Profiles were developed using a main effects orthogonal array. The mean of best-minus-worse scores was estimated, and attribute importance was based on the sum of maximum minus minimum scores for each attribute. Feasibility of eliciting stated preferences was evaluated with t tests and 95 % confidence intervals.Seven attributes (medication, therapy, school, caregiver training, provider specialty, provider communication, and out-of-pocket costs) with three levels each were identified. All mean scores were significant except for pediatrician management of the child's ADHD (p = 0.089). Caregiver training had the highest relative importance, followed by medication and provider communication.The BWS instrument was a relatively simple measure, caregivers completed it independently, and it distinguished the relative importance of different attributes in managing a child's ADHD.