Preferences of Recent Mums in Remote and Rural Areas for Type of Intrapartum Care: A Discrete Choice Experiment.

IF 3.4 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Luis E Loría-Rebolledo, Hugo C van Woerden, Helen Bryers, Seda Erdem, Verity Watson
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Abstract

Background and objectives: Pregnant women living in rural areas considering their preferred place of birth may have to 'trade-off' travel time/distance and other attributes of care (e.g. the full choice of birthplace options is rarely available locally). This study assesses the preferences and trade-offs of recent mothers who live in remote and rural areas of Great Britain.

Methods: An online survey, informed by qualitative research, was administered to women living in rural areas who had given birth in the preceding 3 years. The survey included a discrete choice experiment (DCE) to elicit women's preferences and trade-offs for place of birth. The DCE presented women with a series of eight choice tasks in which place of birth was defined by four attributes: (1) type of facility, (2) familiarity with staff, (3) understanding options and feel relaxed and reassured and (4) the travel time to the place of intrapartum care. DCE data were analysed using an error components logit model to identify preferences.

Results: Across 251 survey responses, holding everything else equal, respondents preferred: intrapartum care in locations with more specialist staff and equipment, locations where they understood their options and felt reassured and where travel time was minimal. Women were willing to travel (92-183 min) to a well-staffed and equipped facility if they understood their options and felt relaxed and reassured. Willingness to travel was reduced if the care received at the specialist facility was such that they did not understand their options and felt tense and powerless (41-132 min).

Conclusion: These insights into the preferences of recent mums from remote and rural areas could inform future planning of rural intrapartum care.

偏远农村地区新妈妈对产前护理类型的偏好:离散选择实验
背景和目标:生活在农村地区的孕妇在考虑自己的首选分娩地点时,可能需要 "权衡 "旅行时间/距离和护理的其他属性(例如,当地很少有完整的分娩地点选择)。本研究评估了居住在英国偏远农村地区的新妈妈的偏好和权衡:在定性研究的基础上,对居住在农村地区、在过去 3 年中生育过的妇女进行了在线调查。调查包括一个离散选择实验(DCE),以了解妇女对出生地的偏好和权衡。离散选择实验为妇女提供了一系列共八个选择任务,其中分娩地点由四个属性定义:(1)设施类型;(2)与工作人员的熟悉程度;(3)了解选项并感到放松和放心;(4)前往产前护理地点的旅行时间。采用误差成分对数模型对 DCE 数据进行分析,以确定偏好:结果:在 251 份调查回复中,在其他条件相同的情况下,受访者更倾向于:在拥有更多专业人员和设备的地点、在她们了解自己的选择并感到放心的地点以及在旅行时间最短的地点接受产前护理。如果妇女了解自己的选择并感到轻松和放心,她们愿意前往人员和设备齐全的医疗机构(92-183 分钟)。如果在专科医疗机构接受的治疗让她们不理解自己的选择,并感到紧张和无力,那么她们出行的意愿就会降低(41-132 分钟):对偏远农村地区新妈妈喜好的深入了解可为今后规划农村产前护理提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Patient-Patient Centered Outcomes Research
Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-
CiteScore
6.60
自引率
8.30%
发文量
44
审稿时长
>12 weeks
期刊介绍: The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.
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