Establishing attributes and corresponding levels for a discrete choice experiment on nurses’ job preferences in Iran

Abstract

AbstractBackgroundDCE is a widely used technique in healthcare to elicit non-market-stated preferences. This study was conducted primarily to identify the most important factors affecting the job preferences of nurses through a scoping review of literature review and qualitative methods, and finally to help select attributes and attribute levels.MethodsThis study was conducted in four stages based on Helter and Boehler’s proposed framework. The first stage was raw data collection to identify the factors influencing nurses’ job preferences. For this reason, a scoping review was performed to identify relevant attributes and their levels. In addition, 7 nurses and experts in the field of nursing were interviewed (in-depth interviews) to identify related characteristics according to the Iranian nursing workplace. Then, 19 nurses were asked to rate the attributes and levels. At this stage, all possible attributes from different sources were gathered. In the third stage, inappropriate attributes were deleted based on acquired qualitative data, and the research team decided which attributes to include in the final design. Attribute wording was done in the final stage. JMP Pro 16 was used to construct the final design. A utility-neutral design was generated and blocked into 3 versions, each consisting of 6 scenarios (choice sets). Finally, a pilot study involving 24 nurses was undertaken in April 2022.ResultsBy using scoping review and qualitative methods such as semi-structured interviews, 23 potential job-related factors that affect nurses’ career choices were identified. Salary, type of employment contract, workload, type of health facility, workplace facilities, work schedule, and Expected time spent on the assigned job for promotion to a higher position were 7 attributes considered in the final design of the scenarios. Internal and face validity, intelligibility, and acceptability of the questionnaire were tested in the pilot study, and minor modifications were made. It was revealed that the respondents in the pilot study were able to understand and answer all of the choice sets with ease.ConclusionSome of the most significant financial and non-financial factors that affect Iranian nurses’ job preferences are mentioned in this study. This indicates that policymakers have a wide range of interventions available that can significantly improve the working conditions of nurses. Additionally, the full description of the attribute development and level selection processes makes this study valuable to the literature on DCE.