Assessments of quality of life using different methodologies have been shown to produce different outcomes with low intercorrelations between them. Only a minority of patients were prepared to trade time for a return to normal vision. Conjoint analysis showed two subgroups with different priorities. Severity of glaucoma influenced the relative importance of priorities.
Having a neighbourhood open space that is attractive and easy to visit can benefit older people's well-being. However, to date little research has explored the comparative importance of different attributes of local open space for older adults. This study drew on a sample of people from across Britain, aged from 60 to 97 years, to address this gap. It used choice-based conjoint analysis of environmental attributes relevant to older people's park preferences to demonstrate the comparative importance of nuisances such as signs of vandalism or dog fouling, and deterrents such as heavy traffic en route to an open space, as well as the importance of attractors such as cafes and toilets, trees and plants, things to watch, and good maintenance. The results published here provide the basis for scenario modelling to predict the effects of changes to any attribute in terms of overall preference. Key subgroups in the sample were identified, their responses differing significantly according to whether or not they lived alone or had any mobility impairment. The value of the research lies in demonstrating the effectiveness of the methods: scenario modelling can take these different subgroups' preferences into account and such analysis can be of considerable practical value to open-space planners and designers.
Purpose -This study aims to examine the environmental attributes relevant to older people's preferences for neighbourhood open spaces. It also aims to explore the association between the relative importance of different environmental attributes and personal and social characteristics in a sample of older people covering a range of geographic locations in the UK. Design/methodology/approach -Choice-based conjoint analysis (CBC) was used to obtain responses from a sample of 237 older people (60 years þ ) living in the UK. A total of 13 environmental attributes were identified from earlier qualitative and quantitative studies. Participants were asked to choose a preferred park from a pair of hypothetical neighbourhood parks differing on four of the attributes presented in a questionnaire. The questionnaire included 14 such tasks. Findings -The results suggest that older people preferred a neighbourhood park which is without nuisance, has cafes and toilets, many trees and plants, light traffic en route, wildlife to watch, and is well maintained. Analyses also reveal that whether or not people live alone, and their functional capabilities in getting around, make a difference in the way they place importance on attributes. Practical implications -The findings can assist those involved in designing and managing outdoor environments to identify salient environmental attributes and prioritise interventions aimed at improving access to, and use of, outdoor spaces for older adults. The approach aids understanding of what is likely to maximise preference and use of open spaces in different segments of the older population. Originality/value -Conjoint analysis procedures are some of the best tools available for determining importance or relative value of attributes of complex environments from the user point of view. The CBC analysis has been employed for the first time in this study to explore the relative importance of such attributes of open spaces for older adults.
In Germany and France, where there is still limited out-of-pocket health spending, the majority of sampled respondents stated that they would purchase meningococcal vaccines with their own money.
Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling.A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6 mean exacerbations?yr -1 ) were recruited.The attributes of exacerbations considered most important were impact on everyday life (20%), need for medical care (16%), number of future attacks (12%) and breathlessness (11%). The next most important attributes were speed of recovery, productive cough and social impact (all 9%), followed by sleep disturbance and impact on mood (both 7%). Importantly, analysis of utility shifts showed that patients most feared being hospitalised, housebound or bedridden. These issues were more important than symptom improvement.Strategies for the clinical management of chronic obstructive pulmonary disease should clearly address patients' concerns and focus on preventing and treating exacerbations to avoid these feared outcomes.
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