乳腺癌患者术后随访服务选择偏好与异质性分析——基于离散选择实验方法  

Analysis of the Preference and Heterogeneity in Postoperative Follow-up Care for Breast Cancer Patients-Based on Discrete Choice Experiment

作　　者：秦美姣 廖冰 蔡舒 陆巧葱 谭颖瑶 杨静 QIN Meijiao;LIAO Bing;CAI Shu;LU Qiaocong;TAN Yingyao;YANG Jing(School of Nursing,Guangdong Pharmaceutical University,Guangzhou 510310,Guangdong Province,China;Department of Nursing,Central People’s Hospital of Zhanjiang,Zhanjiang 524037,Guangdong Province,China;Center for Health Management,Foshan Nanhai District People’s Hospital,Foshan 528225,Guangdong Province,China;Department of Breast surgery,Foshan Nanhai District People’s Hospital)

机构地区：[1]广东药科大学护理学院,广东广州510310 [2]湛江中心人民医院护理部,广东湛江524037 [3]佛山市南海区人民医院健康管理中心,广东佛山528225 [4]佛山市南海区人民医院乳腺外科,广东佛山528225

出　　处：《军事护理》2023年第8期1-5,共5页MILITARY NURSING

基　　金：2021年广东省研究生教育创新计划项目(2021JGXM072)。

摘　　要：目的了解乳腺癌患者术后随访服务的选择偏好及支付意愿,为优化乳腺癌术后随访服务策略提供参考依据。方法应用离散选择实验方法设计问卷,采用方便抽样法选取佛山市5所三级甲等医院232例乳腺癌术后患者为研究对象,构建混合Logit回归模型进行偏好分析。结果影响乳腺癌术后患者选择偏好的属性有:随访人员、随访方式、随访频率、自付费用以及咨询内容等。效用最高组合方案为乳腺专科医生(乳腺专科护士)、面对面随访、提供社会心理学指导、每3个月随访1次、自付费用100元/次。不同年龄、文化程度、工作状况的患者对属性水平的偏好权重不同(均P<0.05)。结论随访人员是乳腺癌术后患者最关注的属性,专科医生是首选,其次是专科护士;建议提升乳腺专科护士在随访服务中的作用,加强社区医疗的专科建设,尊重乳腺癌术后患者偏好,制订个性化随访服务方案。Objective To investigate the preference and willingness to pay of breast cancer patients for postoperative follow-up care and to provide reference for optimizing the strategy of postoperative follow-up for breast cancer patients.Methods The questionnaire was designed with the method of discrete choice experiment,and 232 cases of breast cancer from five level-3 grade-A hospitals in Guangdong province were selected with the method of convenient sampling.A mixed logit model was constructed to estimate breast cancer patients’preferences.Results The attributes that had significant effects on the preferences of breast cancer patients were:follow-up personnel,follow-up method,frequency of follow-up,out-of-pocket expenses,and consultation contents.The most effective combination program was breast specialist(or breast nursing specialist),face-to-face follow-up,providing social psychological guidance,follow-up every three months,out-of-pocket cost of 100 yuan per visit.The patients with different age,education level,and working status had different weights to attribute level(all P<0.05).Conclusions The follow-up personnel is the most valued attribute level of breast cancer patients.Specialist is the most preferred provider followed by nursing specialist.It is suggested that the role of nursing specialist in follow-up should be improved and the specialty construction of community medical service should be strengthened.It is also suggested to develop individualized postoperative follow-up care programs based on the preferences of breast cancer patients.

关 键 词：乳腺癌 随访 偏好 异质性 离散选择实验 

分 类 号：R473.72[医药卫生—护理学]