A Multiattribute Utility Approach to the Prediction of HRT Use or Nonuse Among Midlife Women

2.50
Hdl Handle:
http://hdl.handle.net/10755/155732
Type:
Presentation
Title:
A Multiattribute Utility Approach to the Prediction of HRT Use or Nonuse Among Midlife Women
Abstract:
A Multiattribute Utility Approach to the Prediction of HRT Use or Nonuse Among Midlife Women
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:DeMasters, Janice, MSN/MN/MNSc/MNE
P.I. Institution Name:Saint Louis University
Objective: A common dilemma facing over 43 million American women is choosing whether hormone replacement therapy (HRT) is right for them as they approach menopause and plan for the years beyond. A two-phase study was conducted to analyze this decision process using a multiattribute utility (MAU) approach. A hierarchical model of the factors that influence women’s choices regarding their use of HRT was constructed based on data from focus groups and interviews. In phase 2, the predictive accuracy of that model was tested. The objective of this research was to 1) develop a multiattribute utility model of the HRT decision, 2) evaluate the importance of the factors in that model on the HRT decision among midlife and 2) to test the predictive accuracy of the model. Design: A Multiattribute Utility approach was used for this study. This framework required a two-phase approach. In Phase 1, a hierarchical model of the HRT decision was developed based on focus groups and interviews with midlife women. In Phase 2, the accuracy of the model was tested using a researcher-developed survey tool based on MAU methodology. Population: Participants in this study were healthy women with at least one ovary, eligible for HRT, contemplating or decided about HRT use, and free from contraindications to HRT. The sample was chosen from among employees of a large hospital in the Midwestern United States and the university affiliated with the hospital. The research took place in various settings and was completed in 1999. Concept Studied: Predictive accuracy of an MAU model of the HRT decision was studied. Methods: Subjects were randomly assigned to Phase 1 - model building (n=16) or Phase 2 - model testing (n=80). Phase 1 participants completed a 31-item questionnaire and participated in interviews and focus groups to identify a comprehensive selection of factors in the HRT decision. These factors were used to build an MAU model of the HRT decision. In Phase 2, participants completed the questionnaire. They then filled out a survey tool, giving a numerical value to each factor and groups of factors in the model. Using these values, a score that predicted HRT use or nonuse was calculated. This prediction was compared to self-reported HRT use on the questionnaire. Statistical analysis included discriminate function, logistic regression analysis and cross tabulation techniques. Findings: Two categories of factors were identified: The Advantages and Disadvantages category included Health Protection, Relief of Symptoms, Risk of Cancer and Side Effects. The Perception and Interpretation category included Philosophical Orientation, Care Provider Relationship, Information Processing and Timing Issues. Among women who had never used HRT, symptoms that they felt were not severe enough to warrant HRT use and a dislike for taking medication most influenced their decision. Among current users, the HRT recommendation of their care and relief from hot flashes was most important. For women who had stopped taking HRT, spotting and/or return of menses were most influential. Side effects of HRT swayed women away from HRT use and protection from heart disease, osteoporosis and Alzheimer’s disease most influenced women to use HRT. Side Effects, Health Protection, Philosophical Orientation and Timing Issues best discriminated between user and nonuser groups. The overall predictive accuracy of the model was 93.8%. Conclusion: With a sensitivity of 100% and Specificity of 85.3%, the MAU HRT decision model developed in this study is an excellent predictor of HRT use among this population. Implications: Implications for future research include the extension of this examination of the HRT decision process to other ethnic and socioeconomic groups as well as to hysterectomized women. Ultimately, it lays the groundwork for the development of a tool to predict women who choose not to use HRT and therefore need alternative health choices and closer follow-up in the post-menopausal years.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Multiattribute Utility Approach to the Prediction of HRT Use or Nonuse Among Midlife Womenen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155732-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Multiattribute Utility Approach to the Prediction of HRT Use or Nonuse Among Midlife Women</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">DeMasters, Janice, MSN/MN/MNSc/MNE</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Saint Louis University</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">demasterj@slu.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: A common dilemma facing over 43 million American women is choosing whether hormone replacement therapy (HRT) is right for them as they approach menopause and plan for the years beyond. A two-phase study was conducted to analyze this decision process using a multiattribute utility (MAU) approach. A hierarchical model of the factors that influence women&rsquo;s choices regarding their use of HRT was constructed based on data from focus groups and interviews. In phase 2, the predictive accuracy of that model was tested. The objective of this research was to 1) develop a multiattribute utility model of the HRT decision, 2) evaluate the importance of the factors in that model on the HRT decision among midlife and 2) to test the predictive accuracy of the model. Design: A Multiattribute Utility approach was used for this study. This framework required a two-phase approach. In Phase 1, a hierarchical model of the HRT decision was developed based on focus groups and interviews with midlife women. In Phase 2, the accuracy of the model was tested using a researcher-developed survey tool based on MAU methodology. Population: Participants in this study were healthy women with at least one ovary, eligible for HRT, contemplating or decided about HRT use, and free from contraindications to HRT. The sample was chosen from among employees of a large hospital in the Midwestern United States and the university affiliated with the hospital. The research took place in various settings and was completed in 1999. Concept Studied: Predictive accuracy of an MAU model of the HRT decision was studied. Methods: Subjects were randomly assigned to Phase 1 - model building (n=16) or Phase 2 - model testing (n=80). Phase 1 participants completed a 31-item questionnaire and participated in interviews and focus groups to identify a comprehensive selection of factors in the HRT decision. These factors were used to build an MAU model of the HRT decision. In Phase 2, participants completed the questionnaire. They then filled out a survey tool, giving a numerical value to each factor and groups of factors in the model. Using these values, a score that predicted HRT use or nonuse was calculated. This prediction was compared to self-reported HRT use on the questionnaire. Statistical analysis included discriminate function, logistic regression analysis and cross tabulation techniques. Findings: Two categories of factors were identified: The Advantages and Disadvantages category included Health Protection, Relief of Symptoms, Risk of Cancer and Side Effects. The Perception and Interpretation category included Philosophical Orientation, Care Provider Relationship, Information Processing and Timing Issues. Among women who had never used HRT, symptoms that they felt were not severe enough to warrant HRT use and a dislike for taking medication most influenced their decision. Among current users, the HRT recommendation of their care and relief from hot flashes was most important. For women who had stopped taking HRT, spotting and/or return of menses were most influential. Side effects of HRT swayed women away from HRT use and protection from heart disease, osteoporosis and Alzheimer&rsquo;s disease most influenced women to use HRT. Side Effects, Health Protection, Philosophical Orientation and Timing Issues best discriminated between user and nonuser groups. The overall predictive accuracy of the model was 93.8%. Conclusion: With a sensitivity of 100% and Specificity of 85.3%, the MAU HRT decision model developed in this study is an excellent predictor of HRT use among this population. Implications: Implications for future research include the extension of this examination of the HRT decision process to other ethnic and socioeconomic groups as well as to hysterectomized women. Ultimately, it lays the groundwork for the development of a tool to predict women who choose not to use HRT and therefore need alternative health choices and closer follow-up in the post-menopausal years.</td></tr></table>en_GB
dc.date.available2011-10-26T14:07:20Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T14:07:20Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.