Inpatient versus outpatient management of low-risk pediatric febrile neutropenia: Measuring parents' and healthcare professionals' preferences
Inpatient versus outpatient management of low-risk pediatric febrile neutropenia: Measuring parents' and healthcare professionals' preferences
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DOI：
10.1200/jco.2004.01.077
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发表时间：
2004-10-01
影响因子：
45.3
通讯作者：
Llewellyn-Thomas, HA
中科院分区：
文献类型：
--
作者：
Sung, L;Feldman, BM;Llewellyn-Thomas, HA
目的我们的主要目的是描述和比较父母和医护人员对低风险发热中性粒细胞减少症儿童门诊口服抗生素相对于住院非肠道抗生素治疗的偏好程度。我们的第二个目标是确定口腔门诊治疗偏好强度的预测因素。方法受访者是接受癌症化疗的儿童的父母和儿科肿瘤保健专业人员。首先，描述了住院和门诊的选择，受访者指出了他们最初更喜欢的选择。受访者接下来对七个因素(包括“恐惧/焦虑”和“舒适”)在他们最初做出选择时的重要性进行了排名。结果共有75名家长和42名医护专业人员参与调查。父母(40/75；53%)和医护人员(30/42；71%)最初选择门诊管理的比例没有显著差异(P=0.08)。对于父母来说，对口腔门诊治疗的更强偏好与父母和孩子在家中比在医院更高的预期生活质量相关，在“舒适度”方面的重要性排名较低和较高。相反，“恐惧/焦虑”的重要性排名，对于专业人员来说，只有“恐惧/焦虑”的重要性排名较低，才与门诊口服抗生素治疗的偏好程度较高有关。结论只有53%的父母会选择门诊口服抗生素治疗来治疗低风险发热中性粒细胞减少症。家长和专业受试者对门诊口服抗生素相对于住院非肠道抗生素治疗偏好得分强度的预测因子不同。(C)2004年，由美国临床肿瘤学会提供。
Purpose Our primary objective was to describe and compare parents' and healthcare professionals' strength of preference scores for outpatient oral antibiotic relative to inpatient parenteral antibiotic treatment for low-risk febrile neutropenic children. Our secondary objective was to identify predictors of strength of preference for oral outpatient treatment.Methods Respondents were parents of children receiving cancer chemotherapy, and pediatric oncology healthcare professionals. First, the inpatient and outpatient options were described, and the respondent indicated their initially preferred option. The respondent next ranked how important seven factors (including "fear/anxiety" and "comfort") were in making their initial choice. The threshold technique was then used to elicit the respondent's strength of preference score for oral outpatient, relative to parenteral inpatient management.Results There were 75 parent and 42 healthcare-professional respondents. There was no significant difference (P = .08) in the proportions of parents (40 of 75; 53%) and healthcare professionals (30 of 42; 71%) who initially would choose outpatient management. For parents, stronger preference for oral outpatient therapy was associated with higher anticipated quality of life for the parent and child at home relative to hospital, lower and higher importance rank for "comfort." Conversely, importance rank for "fear/anxiety", for professionals, only lower importance rank for "fear/anxiety" was associated with higher strength of preference scores for outpatient oral antibiotic management.Conclusion Only of 53% parents would choose outpatient oral antibiotic management for low-risk febrile neutropenia. Predictors of strength of preference scores for outpatient oral antibiotic relative to inpatient parenteral antibiotic treatment differed between parent and professional respondents. (C) 2004 by American Society of Clinical Oncology.