Is "end-of-life" care more valuable? Measuring societal views using the new Q2S method

公共部门资源分配是一个重要的研究领域，尤其是现在，削减开支是不可避免的。在卫生部门，这经常引起媒体的关注，特别是在国家卫生和临床卓越研究所的建议和拒绝向病人提供药物方面。然而，决定从有限的资源中提供一种治疗，总是意味着不能资助其他治疗。有效的政策应该包含公众的意见，因此决策者需要了解社会上人们的意见。首先，需要了解公众舆论的性质。围绕这个问题存在什么价值观和争论？通常对某一问题有若干意见，这些意见可以用使它们与众不同的特征以及协商一致的问题来描述。第二，需要了解这些观点在人口中的分布情况-是否有一种占主导地位的观点？什么样的人会有不同的看法？这对决策者来说通常很重要，但需要基于更大样本的不同类型的数据。现有的研究方法可以提供这两种类型的信息，使用不同的方法。在这个项目中，我们使用一种称为Q方法的方法来开发方法，这种方法可以在一种一致的方法中将这两种类型的信息联系起来。我们在这里讨论的问题是对社会的价值？生命终结技术.关于拒绝为绝症患者提供昂贵药物的决定是有争议的，这些药物只能延长生命很短的时间。我们将探讨公众对提供临终关怀技术的意见，这将为NICE和当地组织提供有关医疗保健资源的决策。我们的研究将分两个阶段进行：第一阶段将涉及从普通人群中抽样的250人和从特定利益群体中抽样的50人。他们将根据协议将印有意见陈述的卡片分类到网格上。基于对受访者之间共同模式的分析？我们将识别和描述共享视图。在第二阶段，我们将利用这些调查结果设计一项调查，使我们能够分析这些观点在一个大的、有代表性的人口样本中的普遍程度。

Public sector resource allocation is an important area for research, especially now, when spending cuts are inevitable. In the health sector this frequently attracts media attention, especially with respect to the recommendations of the National Institute for Health and Clinical Excellence (NICE) and the denial of drugs to patients. However decisions to provide one treatment from a limited pot of resources will always mean that something else cannot be funded.Effective policies should incorporate the opinions of the general public and so policy makers need information about the views held by people in society. Firstly, information is needed about the nature of public opinion. What values and arguments exist around the topic in question? Usually there are a number of opinions about a particular issue and these can be described in terms of the features that set them apart as well as issues of consensus. Secondly, information is needed on how those views are distributed in a population - is there a dominant view? and what kinds of people subscribe to different opinions? This is often important for decision makers but requires a different kind of data based on larger samples of people. Research methods exist which can provide information of both types, using different approaches. In this project, we develop methods using an approach called Q methodology, which can link these two types of information within a consistent methodological approach. The issue we address here is the value to society of ?end-of-life? technologies. Decisions about the denial of expensive drugs for terminally ill patients, which extend life by only a short time, are controversial. We will explore the views of the general public regarding the provision of end-of-life technologies which will inform NICE and local organisations who make decisions about resources in health care. Our research will be conducted in two phases: the first will involve 250 people sampled from the general population and 50 from specific interest groups. They will sort cards, printed with statements of opinion, onto a grid, according to agreement. Based on an analysis of common patterns between respondents? sorts we will identify and describe shared views. In a second phase we will use these findings to design a survey which will allow us to analyse how common these views are in a large, representative sample of the population.