Assessing patients' preferences for treatments for angina using a modified repertory grid method
Assessing patients' preferences for treatments for angina using a modified repertory grid method
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DOI：
10.1016/j.socscimed.2004.10.019
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发表时间：
2005-06-01
影响因子：
5.4
通讯作者：
Thomson, R
中科院分区：
文献类型：
--
作者：
Rowe, G;Lambert, N;Thomson, R
当前医学上的一个热门主题是患者是否以及如何参与治疗选择。假设患者的参与是可取的，那么一个人应该如何着手获得偏好呢？可用于这一目的的定量和定性方法有多种，其中之一是保留网格法。这种方法包括通过比较三个选项的集合来得出偏好的结构(原因)。这种方法允许结构化地得出个人偏好背后的原因，但当与广义普罗克斯特分析(GPA)一起使用时，也允许聚合个人数据以揭示总体偏好模式。在这项研究中，使用储备网格方法来检查患者对心绞痛治疗的偏好，目的是首先了解患者偏好的一般模式，然后检查该技术在这种设置中的可能实用性。来自英国诺福克两个普通诊所的21名轻度和稳定型心绞痛患者的样本使用保留网格法进行了采访，以得出他们在七种心绞痛治疗方法(包括不治疗)中潜在的偏好。然后制作个性化的问卷并发送给患者进行自我完成，这需要对每个结构与每个治疗相关的程度进行评级(在视觉模拟评分表上进行评分)。使用GPA对评级进行分析表明，这些概念围绕着两个维度：“一些治疗”和“不治疗”，以及药物治疗和手术治疗。虽然一些治疗通常比不治疗更受欢迎，但个人对药物治疗或手术治疗的偏好有所不同。虽然后者通常被认为是“有效的”，但它们也被认为是“侵入性的”、“可怕的”、与“消极经历”有关的、更适合于症状严重的时候(“相称”)。我们考虑了这些结果对患者选择治疗方案的影响。(C)2004爱思唯尔有限公司。保留所有权利。
A current popular theme in medicine concerns whether and how patients should be involved in treatment choice. Assuming patient involvement is desirable, how should one go about eliciting preferences? A variety of quantitative and qualitative methods exist that may be used for this purpose, one of which is the repertory grid method. This method involves eliciting constructs (reasons) for preferences through comparing sets of three options. This method allows the structured elicitation of the reasons behind individual preferences, but also, when used with generalised procrustes analysis (GPA), allows aggregation of individual data to reveal general preference patterns. In this study the repertory grid method was used to examine patient preferences for angina treatments with the goal of, first, gaining some understanding of general patterns of patient preference, and second, examining the likely utility of the technique in this setting. A sample of 21 patients with mild and stable angina from two general practices in Norfolk, UK was interviewed using the repertory grid method to elicit the constructs underlying their preferences amongst seven angina treatments (including 'no treatment'). Individualised questionnaires were then produced and sent to the patients for self-completion, which required rating the extent to which each construct was relevant for each treatment (scored on visual analogue rating scales). Analysis of the ratings, using GPA, showed that the constructs clustered around two dimensions: 'some treatment' versus 'no treatment', and drug treatment versus surgical treatment. While some treatment was generally preferred to no treatment, individuals varied in preference for drug treatments or surgical treatments. Although the latter were generally perceived as 'effective' they were also perceived, for example, as 'invasive', 'frightening', related to 'negative experiences', and being more appropriate for when symptoms are severe ('proportionate'). We consider the implications of these results for involving patients in choosing amongst treatments. (c) 2004 Elsevier Ltd. All rights reserved.