應用聯合分析法探討乳癌婦女對輔助性藥物治療之態度

Eliciting patients' preferences for adjuvant chemotherapy options in the treatment of breast cancer

洪鈺雯(Yu-Wen Hung)

指導教授 ： 湯澡薰

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2011年)

摘要

本研究之主要目的在於瞭解早期乳癌婦女對於輔助性藥物治療方案的態度，並探討影響的選擇因素及這些選擇因素間的取捨關係。研究發現期能作為藥廠相關新產品及新治療方式的開發過程中，能尋求更符合目標族群偏好的治療方式及產品。
　　本研究採問卷調查方式，立意取樣60位台北地區兩間醫學中心的乳癌早期、年齡六十歲以下之婦女。統計分析使用多項式邏吉特模型與群集分析，探討乳癌婦女對乳癌輔助性藥物五個治療方案的重視程度與偏好結構，五個治療方案的屬性則包含給藥途徑與頻率、療程長度、心臟毒性的影響、復發率及自費金額。
　　研究結果顯示，多數受訪婦女在療程長度及心臟毒性的影響兩個屬性水準方面，相較於較長時間及有心臟毒性影響是正的偏好；而復發率及自費金額為負的偏好，綜合上述結果來說，受訪者喜歡每月注射一次、療程長度1年、無心臟毒性、復發率及自費金額愈低愈好的治療方案。經因素分析的分群，探討不同健康生活型態的受訪者其偏好狀況，研究顯示偏好狀況與全部樣本的偏好狀況雷同。
　　根據研究結果，本研究提出下述建議：一、建議醫療政策制訂及醫療產品或治療方案研發者將聯合分析法用於醫療市場中新產品、新藥物與新治療方式的市場調查以尋求更符合目標族群偏好的方式及產品。二、建議後續研究者在決定屬性水準時須謹慎思考、多參酌專家意見，並同時建立許多問題加以衡量受訪者的行為及心理層面，以利將受訪者分類進行群集分析，方能更確立每個治療或篩檢服務的目標族群及可以推行的策略與方案。

關鍵字

聯合分析 ； 乳癌輔助性藥物治療 ； 偏好

並列摘要

The purposes of this study were to understand the attitude of early stage breast cancer women for adjuvant chemotherapy, their related factors and trade-off between the factors. Period can be as in the medical market new products and new treatment development process more in line with the target groups to seek ways and product preferences.
This study employed the method of questionnaire, purposefully sampling 51 of breast cancer women under age 60 of two medical centers in Taipei. The statistical analysis used both multinomial logit model and cluster analysis, exploring women’s emphasis on and preferences for the attributes of adjuvant options in the treatment of breast cancer. There were five attributes designed to elicit women’s preferences for the options of the treatments, including frequency and administration, length of treatment, cardiac toxicity , recurrence rate and out of the pocket money.
The study results showed on the length of treatment and cardiac toxicity two attributes most women were significantly preferred to shorter length and no cardiac toxicity options. But they all showed no preferences for the recurrence rate and out of the pocket money. Therefore, the women like one pill per month, 1year of length of treatment, no cardiac toxicity, recurrence rate and out of the pocket money lower. Through the factor analysis to explore these women were of different health-promoting lifestyles, the results showed the same with All women.
Base on the finding, there are two suggestions：(1) The health policy makers and product developers of health and treatment options can use the Conjoint analysis for the health care market in new products, new drugs and new treatment market research to explore more in line with the target groups preferred method and product. (2) The follow-up researchers in determining the properties to be careful thinking, taking into account any more expert opinion; and also create many problems to be measured respondents' behavior and psychological level, to facilitate the classification of the respondents cluster analysis, to establish the treatment or screening services for the target groups and possible implementation strategies and programs.

並列關鍵字

Conjoint analysis ； Adjuvant chemotherapy of breast cancer ； Preferences

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