Preferences of follow-up services patients with critically ill patients: Attributes development for a discrete choice experiment

Preferences of follow-up services patients with critically ill patients: Attributes development for a discrete choice experiment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Preferences of follow-up services patients with critically ill patients: Attributes development for a discrete choice experiment Junlan Dong, Zhixia Jiang, Linlin You, Xiaoli Yuan, Sijin Li, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7911777/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Adherence to follow-up services among intensive care unit (ICU) discharge patients is often low, contributing to poor prognosis. Understanding these patients’ needs and preferences is essential for designing effective follow-up programs. The discrete choice experiment (DCE) offers a structured approach to quantifying such preferences, with the selection of attributes and levels being a critical step. Objective To describe the systematic process used to identify, refine, and finalize attributes and levels for a DCE on post-discharge follow-up care for ICU patients. Methods A mixed-methods approach was applied in three phases: (1) an extensive literature review to generate an initial pool of attributes and levels; (2) 16 in-depth interviews with former ICU patients to explore their experiences, needs, and expectations for follow-up care; (3)an expert panel meeting was convened to refine and validate these attributes and (4) Four focus groups were formed, each consisting of ICU survivors to clarify terminology, ensure patient-centered relevance, and prioritize attributes through a voting-based ranking process. Results Seven key attributes were finalized, each with two to four levels: follow-up content, route, frequency, personnel, mode, duration, and cost. These attributes reflect not only the logistical aspects of follow-up care but also the components most valued by patients for improving recovery and long-term health outcomes. Conclusions This mixed-methods strategy effectively integrated evidence, patient experience, and group consensus to generate attributes and levels that are both clinically relevant and patient-centered. The approach may serve as a model for other studies seeking to design DCEs in healthcare settings, ensuring that the attributes examined align closely with the priorities of the target population. Intensive care unit (ICU) patients Post-discharge follow-up Patient preferences Discrete choice experiment Mixed-methods study Figures Figure 1 Introduction With the development of critical care medicine, the number of patients admitted to intensive care units (ICUs) is increasing, and the survival rate of ICU patients has reached 90% [1–2]. However, depending on age and severity of critical illness, mortality at 1 year after ICU discharge remains high, ranging from 10% to 30% [3–5]. In addition, ICU patients often develop physical, psychological, and cognitive impairments classified as post-intensive care syndrome (PICS) [6–7]. This syndrome is associated with heightened mortality rates, elevated rates of readmission, and challenges in reintegrating into societal roles or returning to the workforce, ultimately resulting in diminished health-related quality of life. Given the complexity of post-discharge needs—combined with insufficient capacity of primary healthcare institutions, heavy family caregiving burden, and limited caregiver expertise—home rehabilitation after ICU discharge faces substantial challenges. Scientific and effective follow-up care can improve patients’ physical, psychological, cognitive, and social functioning, while reducing mortality and healthcare utilization [8]. However, patient compliance with follow-up care is shaped by multiple interrelated factors, including personnel type, delivery method, frequency, duration, content, and disease progression [9–10]. These follow-up design decisions are preference-sensitive—there is no single universally optimal choice, and the “best” plan depends on the individual patient’s values and priorities. This aligns with the principles of Patient-Centered Care (PCC), which emphasize tailoring healthcare to patient preferences, and Shared Decision-Making (SDM), which provides a structured approach for incorporating those preferences into clinical decisions. The Discrete Choice Experiment (DCE) is a robust stated-preference method that directly operationalizes PCC and SDM principles, allowing researchers to identify, quantify, and prioritize attributes of care from the patient’s perspective [11]. In recent years, DCEs have been widely applied to assess patient preferences in cancer follow-up care [12,13], demonstrating that such patient-centered strategies can improve compliance by 41%–67% [14]. A systematic review also supports that patient-centered follow-up strategies enhance adherence and satisfaction [15]. Established methodological guidelines highlight the critical role of systematically developing and validating attributes and levels in DCEs [16–17]. Yet, many studies merely outline their attribute identification methods without detailing a structured, theory-informed process [11,18]. Grounded in PCC and SDM, the present study aims to identify, refine, and select follow-up attributes and levels that reflect ICU patients’ preferences, thereby providing an evidence-based foundation for designing patient-centered post-ICU follow-up programs. Theoretical Framework This study was grounded in the Patient-Centered Care (PCC) framework and the principles of Shared Decision-Making (SDM). PCC emphasizes delivering healthcare that respects and responds to the preferences, needs, and values of individual patients, ensuring that these elements guide all clinical decisions. In the ICU discharge context, follow-up care design is inherently preference-sensitive—multiple clinically appropriate options exist, and the optimal choice depends on the patient’s unique circumstances and priorities. SDM complements PCC by offering a structured, collaborative process in which patients and clinicians jointly consider clinical evidence and personal values to arrive at informed decisions. The Discrete Choice Experiment (DCE) method was selected because it operationalizes these theoretical principles, enabling the systematic elicitation and quantification of patient preferences across multiple care attributes. Grounding the attribute development process in PCC and SDM ensured that the resulting follow-up framework was both scientifically rigorous and aligned with core principles of patient-centered care. Methods This study adopted an exploratory sequential mixed-methods design in accordance with the framework proposed by Creswell and Plano Clark (2018). This design enables the rigorous integration of qualitative and quantitative data to comprehensively address the research questions related to ICU patient follow-up care preferences. Study design Step 1: Scoping Review The literature review in this study was conducted as a systematic scoping review in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. This approach was selected to ensure methodological transparency and reproducibility. Research Question Which attributes and levels of follow-up needs can be identified for ICU patients based on the existing literature? Search Strategy A comprehensive search was performed in Embase , PubMed , Web of Science , Chinese National Knowledge Infrastructure (CNKI) , and Wanfang Database , covering all available publications from database inception to May 2023. The search strategy was developed in consultation with an experienced medical librarian to maximize sensitivity and specificity. Keywords were derived from a combination of Medical Subject Headings (MeSH) terms and free-text keywords. For example, in PubMed, MeSH terms included Critical Illness , Patient Compliance , and Continuity of Patient Care . Free-text terms such as "follow-up," "patient adherence," and "patient preferences" were included to capture studies not yet indexed or lacking appropriate MeSH terms. For the Chinese databases (CNKI and Wanfang), equivalent controlled vocabulary and free-text terms were applied. When a keyword was not available in recognized thesauri, its inclusion was justified based on its frequent use in relevant prior studies and expert consensus. The complete search strings for each database are provided in Table1 . Eligibility Criteria Studies were included if they: 1.Focused on critically ill patients aged ≥18 years post-discharge from the ICU. 2.Addressed follow-up adherence, preferences, or experiences. No restrictions were applied to study design. Only English and Chinese publications were considered Study Selection After duplicate removal, two reviewers independently screened titles and abstracts, followed by full-text assessment for eligibility. Disagreements were resolved through discussion, with a third reviewer acting as arbiter when consensus could not be reached. Quality assessment (QA Score)In this study, the Quality Assessment (QA) score was calculated based on standardized critical appraisal tools appropriate for the study designs included. Specifically, tools such as the Joanna Briggs Institute (JBI) critical appraisal checklist [19] and the Cochrane Risk of Bias tool [20] were employed. Two independent reviewers assessed each study across multiple domains including study design, sample size adequacy, outcome measurement validity, and data analysis transparency. The scores from these domains were summed to generate an overall QA score, with higher scores indicating better methodological quality. Data Charting and Synthesis Two reviewers independently extracted data on author, year, location, objective, study design, surgical intervention (if applicable), sample size, and identified attributes with their corresponding levels. Data were charted in a standardized extraction form adapted from the JBI template. Extracted data were collated, summarized, and presented in tabular and narrative form, resulting in a preliminary inventory of attributes and levels for subsequent phases of the study. Step 2: In-depth interviews Patient recruitment. To gather insights regarding the experiences and requirements of critically ill patients upon their discharge, we conducted a recruitment process targeting patients from the Intensive Care Unit (ICU) of a tertiary medical facility located in Zunyi City, spanning from October 2022 to December 2022. We implemented purposeful sampling techniques to ensure a comprehensive variation in the patient experiences. The inclusion criteria established were as follows: 1) Participants must be aged 18 years or older; 2) A minimum ICU stay of 48 hours, with mechanical ventilation for at least 24 hours; 3) Patients must be conscious and capable of communication at the time of transfer from the ICU. Individuals diagnosed with malignant tumors or those experiencing disorders of consciousness that hindered effective communication were excluded from the study. All participants provided written informed consent prior to their inclusion. Data collection The duration of each interview is approximately 30 to 60 minutes. Researchers contact the interviewees in advance to provide a detailed explanation of the purpose and significance of the interview. After obtaining their consent, researchers jointly determine the time and select an independent and quiet office as the location of the interview. Before starting the interview, researchers obtain the consent of the hospital ethics committee and sign an informed consent form with the interviewee. Based on the initial attributes and specific needs classification obtained from literature reviews, we developed a semi-structured interview outline focusing on themes related to individual follow-up experiences. The content specifically covers: 1) Follow-up perceptions and perspectives; 2) Factors affecting patient adherence to follow-up; 3) Post-discharge status and needs; 4) Post-discharge follow-up content and plans.The final interview guide was refined through the pilot interviews (see Table S2). Before the interview began, each patient completed a brief questionnaire on socio-demographic and clinical characteristics. All interviews were recorded with permission and transcribed verbatim. When no new attributes were identified, saturation was reached. Data analysis. Data collection and analysis occurred simultaneously, employing thematic analysis to interpret the transcripts [11]. In the first phase, codes and themes were derived from a predetermined list of attributes and their associated levels, which pertain to distinct characteristics and categories pertinent to the research. Following this, we conducted a review of the established codes and themes and generated Step 3: Expert Panel Analysis Following the identification of preliminary attributes and levels through literature review and semi-structured interviews, an expert panel meeting was convened to refine and validate these attributes. Given that including an excessive number of attributes can increase participant burden and complicate the discrete choice experiment (DCE) questionnaire, a range of 5 to 8 attributes was deemed appropriate to balance comprehensiveness and feasibility [21]. Expert Selection The expert panel was purposively sampled from clinical specialists in critical care within our institution. Selection criteria included:1)A minimum educational attainment of a bachelor’s degree or higher;2)Professional rank of associate senior level (equivalent to associate professor) or above;3)At least 10 years of relevant clinical experience;4)Active involvement in critical care, encompassing both physicians and clinical nurses;5)Voluntary consent to participate in the study. Panel Procedures The panel’s objectives were to:1)Assess the appropriateness and relevance of the preliminary attributes and their specific items in capturing the follow-up needs and preferences of critically ill patients;2)Review and propose necessary modifications to the content and definitions of each attribute and its levels. Data Analysis Descriptive statistics were calculated using SPSS 29.0. Continuous variables are presented as mean ± standard deviation, and categorical variables as frequencies and percentages. Expert engagement was evaluated based on attendance rates and the extent of active feedback, with higher participation indicating greater expert involvement. The authority of expert judgments was quantified via the expert authority coefficient (Cr), calculated as the average of the judgment basis (Ca) and familiarity (Cs): Values of Cr range from 0 to 1, where higher values denote stronger expert authority. A threshold of Cr ≥ 0.7 was applied to indicate acceptable reliability of expert input. Step 4: Focus groups Participants in the focus group provided insights through brief activities designed to validate and refine the attributes and levels identified during the in-depth interviews. The focus group sessions were conducted in a confidential area of the hospital and facilitated by an independent moderator supported by an assistant. Importantly, the focus group participants were not the same individuals who took part in the in-depth interviews ; instead, a purposive sampling method was used to recruit new participants who had been discharged from the intensive care unit in December 2022. These participants were organized into four distinct focus groups based on their ICU admission periods, with each group consisting of 4 to 5 members. The inclusion criteria for focus group participants were consistent with those used for the in-depth interviews to ensure comparability. The focus group discussions resulted in clarification and refinement of attribute terminology, improved understanding of patient perspectives, and a prioritization of attributes through a voting-based ranking process. These outcomes contributed to streamlining the preliminary list of attributes into a manageable and patient-relevant set for subsequent discrete choice experiment design. The activities conducted within the focus groups were systematically organized into three distinct phases. In the initial phase, participants assessed the significance of each attribute and level presented, relating them to their personal experiences. They were also encouraged to propose any additional attributes and levels that they deemed critical when considering options for Follow-up programme. Following this, a ranking exercise was performed to streamline the number of attributes to a more manageable set suitable for a Discrete Choice Experiment (DCE) [22]. Participants ranked the newly identified attributes, assigning points ranging from 3 for the most significant attribute to 1 for the least significant. Subsequently, the average importance score for each attribute was computed by dividing the aggregate points assigned to each attribute by the total number of participants from all focus groups [22]. Participants individually ranked the attributes according to their relevance, and the mean scores reflected the collective ranking of the group [23]. Utilizing these mean importance scores, we arranged the attributes from the most important (highest mean) to the least important (lowest mean). An excessive number of attributes has the potential to complicate the task for participants, which could result in inconsistent responses across different choice scenarios or lead to participants overlooking certain attributes during their decision-making process [24]. Consequently, in alignment with the preceding discrete choice experiment, we intend to incorporate the eight most significant attributes in our subsequent study [23]. Finally, a group discussion was convened to evaluate the patients' rankings as well as the phrasing of the attributes and levels. Both researchers and focus group participants scrutinized the clarity and consistency of the meanings and interpretations associated with the attributes. This group discussion persisted until all attributes and levels were thoroughly and explicitly articulated. Ethics approval and consent to participate Informed consent was obtained from participants at the beginning of the survey. Those participating in face-to-face interviews provided written consent, while participants in telephone interviews gave verbal consent, which was documented by the interviewer, as written consent was not obtainable. This consent procedure was approved by the ethics committee. Results Step 1: A literature review The literature search resulted in a total of 1,178 publications (PubMed: n = 586; Embase: n = 182; Web of Science: n = 293; CNKI: n = 12; Wanfang: n = 105). Following the elimination of 360 duplicate entries, 818 records were retained for the eligibility assessment. Initial screening conducted through titles and abstracts led to the exclusion of 768 articles. Subsequently, 50 articles were thoroughly reviewed for eligibility, and 28 of these were further excluded. In the end, eight studies satisfied our predetermined inclusion criteria [25-32]. The selection process is visually summarized in Figure 1. The characteristics of the included studies are detailed in Table 1. From the data analysis, our research team reviewed the attributes and levels derived from the literature review, ultimately identifying 13 distinct attributes. Its related attributes and levels are presented in Table 2.However, due to the absence of specific values related to the cost attribute in the literature, we were unable to conduct a level analysis for this particular attribute. Table 1. Study characteristics. Study Objective Location Study design QA score Sample size(n) Attributes(levels) Engstromet al. [25] (2008) To describe how ICU survivors and families experience a post-discharge, follow-up visit to the ICU. Sweden Qualitative study 8/10 (80%) N = 9 Gain strength from being back together; gain understanding of the experience of a critically ill patient; gain gratitude for surviving; and gain possibilities for improved care. Chatzaki 2012[26] To defifine families’ needs, using the Critical Care Family Needs Inventory (CCFNI), in Crete, Greece. Greece Cross-sectional study 7/8 (87.5%) N = 230 Regardless of participants' backgrounds, ensure that needs projects are consistently selected as the most important. Participants with lower educational and socioeconomic status will support needs projects to be rated as more important than those with higher status. Czerwonka et al. [27] (2015) A pilot study to explore survivors’ and families’ needs throughout the recovery continuum using the Timing it Right framework. Canada Framework Methodology 8/10 (80%) N = 7 The study identified a central theme: survivors undergoing critical illness rehabilitation often lack sustained medical care. Three subthemes highlight key aspects: (1) Information needs evolve throughout the nursing process, (2) Fear and anxiety emerge when families remain uncertain about outcomes, and (3) Survivors transition from dependency to independence Schofield-Robinson [28] (2018) objective was to assess the effectiveness of follow-up services aimed at identifying and addressing the unmet health needs of ICU survivors following their ICU stay. England Non-experimental observational study 7/10 （70%） N=1707 Type of lead provider: Nurse-led vs. multidisciplinary team Mode of delivery: Face-to-face vs. telephone consultations Frequency: Weekly, monthly, every six months, or up to eight sessions Timing and duration of follow-up varied across studies Van Sleeuwen 2020[29] To explore health issues in families of intensive care survivors and the consequences for their daily lives Netherlands Thematic Analysis 8/10 (80%) N = 13 The issues addressed are categorized into six themes: (1) Physical functions (e.g., fatigue, headaches, and increased discomfort); (2) Mental health (e.g., anxiety, heightened stress, and difficulty expressing emotions); (3) Survival aspects and future concerns (e.g., uncertainty about the future); (4) Quality of life (e.g., loss of personal freedom); (5) Relationships and social engagement (e.g., experiencing lack of understanding); (6) Daily functioning (e.g., cessation of work). Tate 2020[30] To explore positive experiences of caring for an intensve care survivor and describe factors viewed as important for a positive experience USA Content Analysis 10/10 (100%) N = 41 During the hospital stay, caregivers described how their roles shifted, with their primary responsibility shifting to defending the patient. They explained how this experience fulfilled their identity and strengthened their bond with the patient. Most family caregivers emphasized the importance of social support and prayer. Hajalizadeh(2021)[31] This study aimed to determine the informational needs of families of patients discharged from Intensive Care Units (ICU), Kerman, southeast Iran. Kerman, southeast Iran a cross-sectional design Not reported N=140 the maximum need was associated with self-care subscale (4.89 out of 5), and the minimum need was associated with defecation (3.13 out of 5) Clarke R.[32] (2022) The aim of the service evaluation was to generate knowledge on experiences of psychological and physical rehabilitation in intensive care, on other hospital wards and at home to inform the development of an Intensive Care follow up clinic Britain Content Analysis Not reported N = 20 （ Themes ） ： Sense making difficulties Rehabilitation context Sense of self （自我感知） （ Sub-themes ） ： Sense making difficulties ：memory gaps、delirium、lack of information、anxiety Rehabilitation context ：ICU environment、transitions、isolation and abandonment、valued support Table 2. Initial attributes and levels obtained from the literature review. Serial number Attributes Levels 1 Follow-up content Care guidance and support information requirements Psychosocial support 2 Follow-up route section for outpatients Telephone Network Home follow-up 3 frequency once a week once every month Once every three months 4 Follow-up time 1.5-10min 2.11-30min 3.＞30min 5 Follow-up provider ICU Doctor ICU nurse Multidisciplinary team 6 Follow-up mode Follow up alone Participate with family 7 duration 3 months 6 months 12 months 8 cost 9 place Visiting Hospital Community Hospital Home 10 time quantum morning Afternoon Evening 11 Primary supplementary service (memory retrieval) Need Not need Step 2: In-depth interviews Development of the interview and focus group guides: The semi-structured interview guide used to identify attributes for the discrete choice experiment (DCE) was adapted from a protocol published by Lee et al. [33] in their study on oral nutritional supplement preferences among gastric cancer patients (Reference: Journal of Human Nutrition and Dietetics, 35(4), 678–686). Minor modifications were made to align with the acute postoperative context of our study, including the addition of questions on Added Questions:Follow-up content specificity (e.g., "How acceptable is a weekly follow-up schedule in the first month after leave hospital?")Follow-up duration preferences (e.g., "Would you prefer a short-term follow-up (≤1 month) or a long-term follow-up (>3 months) for after leave hospital guidance?").Removed Content:Sections on long-term cost-effectiveness analysis for chronic disease management were excluded.Focus group implementation: The adapted guide informed both the in-depth interviews and subsequent focus group discussions. Participants in the focus group provided insights through brief activities (e.g., ranking exercises, scenario-based discussions) to validate and refine the attributes and levels identified during the interviews. Sessions were conducted in a confidential hospital area by an independent moderator trained in qualitative research, supported by an assistant for note-taking and logistics. Description of the sample A total of 14 patients transferred from the ICU were interviewed in this study, and the 14 interviewees were numbered as N1~N14 respectively. Table 3 displays the socio-demographic and clinical characteristics of the patients. Through these interviews, three new attributes were identified: "cost," "ICU memory compensation," and "follow-up subject selection." Participants indicated that considering paying a certain fee during follow-up was also an important factor in their decision to continue long-term follow-up.The attributes and hierarchy extracted from the in-depth interviews are shown in Table 4 Table 3. Sociodemographic and Clinical Characteristics of ICU Participants (n = 14) ID Gender Age (years) Education Level Occupation Diagnosis (ICD-10) ICU Stay Duration (days) N1 Female 54 Junior High Freelancer Acute suppurative cholangitis (K83.0) 4 N2 Male 60 Primary School Farmer Septic shock (R57.2) 4 N3 Female 66 Junior High Unemployed Multiple injuries (T07) 11 N4 Male 60 Primary School Farmer Gastrointestinal perforation (K63.1 / K31.5) 7 N5 Female 49 Junior High Freelancer Ruptured anterior communicating artery aneurysm with hemorrhage (I67.1) 29 N6 Male 34 Junior High Freelancer Intestinal obstruction (K56.6) , peritonitis (K65.0) 14 N7 Female 40 Primary School Freelancer Renal dysfunction (N28.9) 6 N8 Female 58 Bachelor’s Employed Pulmonary infection (J18.9) 8 N9 Male 20 Bachelor’s Student Diabetic ketoacidosis (E10.1 / E11.1) 12 N10 Male 47 Junior High Freelancer Acute respiratory failure (J96.0) 15 N11 Female 29 Bachelor’s Employed Acute liver failure (K72.0) 3 N12 Male 58 Primary School Unemployed COVID-19 (U07.1) 14 N13 Male 58 Junior High Unemployed Pulmonary infection (J18.9) 4 N14 Female 34 High School Freelancer Gastrointestinal perforation (K63.1 / K31.5) 6 Table 4. Included attributes and levels from in-depth interviews Attributes Levels Quote excerpted from transcribed interviews Follow-up content 1.Care guidance and support 2.information requirements 3.Psychosocial support “After discharge, I need some support, such as guidance on diet and rehabilitation exercises.” “I want to know the precautions after discharge, such as what can be done and what cannot be done.” “I feel that after being hospitalized, my mood is always very low and I need medical staff to communicate with me emotionally to make me feel at ease.” Follow-up method 1.via outpatients 2.via Telephone 3.via Network 4.via Home follow-up “I think for me, making a phone call is the most convenient and communicating through the phone is the most suitable.” “I would prefer to choose medical staff to communicate with me face-to-face so that I can detect changes in my condition.” “It would be great if medical staff could come and guide me on the care of my stoma and the precautions for peritoneal dialysis, even if I paid a certain fee. It would be inconvenient to go to the hospital”. “If the hospital has a WeChat account, our patients and family members can communicate and communicate through WeChat, which can better provide us with guidance on health.” Follow-up provider ICU nurse ICU doctor Multidisciplinary team “I hope to be followed up by the supervising doctor of the ICU, as I have a good understanding of my condition and can rest assured of future consultations.” “I think my bed nurse in the ICU has the most contact with me. I think she is very kind and patient with me. If she were to follow me up after discharge, it would be great.” “I also have rehabilitation therapists in the ICU for rehabilitation training. I hope they can guide my recovery after discharge, and the doctors can provide guidance on my condition.” Follow-up mode 1.Follow up alone 2.Participate with family “I think it's enough to communicate with me for follow-up guidance after discharge, and I don't want my family to be involved to avoid their concerns.” “After discharge, please contact my husband. I dare not face the prognosis after discharge. You can contact him and let him talk to me.” Duration of follow up 1.3 months 2.6 months 3.12 months “I think it's okay to communicate with me once or twice a month, but the situation in the later stage will also be adjusted according to the changes in the condition. Of course, once it's okay and cured, I think there's no need to communicate.” “Just three months before discharge, you can contact me more frequently. Of course, I hope the hospital's care for me can last for six months or even a year. It's always good to call and care when you have time.” cost “If I can meet my needs after discharge, I don't have to go to the hospital frequently. I can accept paying a certain fee appropriately.” “I feel very helpless after being discharged from the hospital. I have many questions but I don't know who to ask. If the hospital can provide us with these help, I think I can accept paying fees below 100 yuan.” Place 1.Visiting Hospital 2.Community Hospital 3.Home “Of course, it would be very convenient for me if medical staff could come home to provide me with prognosis guidance and follow-up.” “Since I am not local to Zunyi, it is not realistic for me to come to the hospital for follow-up treatment. The round-trip fare is only a few hundred yuan, as well as accommodation costs. I would rather choose our local community hospital, which is close to home, as they may not be very familiar with my condition.” “My family lives in Huichuan District, and it's also convenient to come to the hospital. I prefer to come to the hospital to communicate with the doctors face-to-face, and I always feel more at ease.” time quantum Morning Afternoon Evening “For time selection, I think it's okay, but it might be better in the morning, with more energy, and I can better follow the guidance.” “I tend to work at night and during the day, and I don't want my mood to be affected by medical guidance.” Primary supplementary service (memory retrieval) Have Not have “I have no idea about my hospitalization experience in the ICU. When I entered, I was in a coma, and I don't want to recall that memory now. I don't know, it's great.” “I am in a semi conscious and semi unconscious state inside, and I am not very clear about what I experienced. I just feel my hands and feet tied up, and I am actually quite curious about that experience.” frequency 1.once a week 2.once every month 3.Once every three months “I hope to provide regular assistance, preferably 2-3 times a month or once a week, for guidance.” “I hope the hospital will communicate and guide us at least once a month.” “I think I am in good condition, but I don't need to contact too frequently. Just communicate and consult once every two to three months.” Follow-up time 1.5-10min 2.11-30min 3.＞30min “I think time can be limited based on the prognosis. If there are many problems, more communication and consultation can be done, such as about half an hour. If there are few problems, a time period of 5-10 minutes can be sufficient.” “I hope the hospital can help me for a longer time, patiently answer my questions, not just for completing tasks, but for genuinely caring about my condition and providing patient guidance.” Step 3: Expert Panel Analysis A total of eight critical care experts with associate senior professional titles or above were included in the study. The panel comprised three physicians and five nurses, aged between 34 and 52 years, with professional experience ranging from 13 to 29 years. Educational backgrounds included one with a doctoral degree, three with master’s degrees, and four with bachelor’s degrees. Detailed characteristics are presented in Table 5. Table5. Demographic and Professional Characteristics of Included Experts ID Sex Age (years) Education Professional Title Specialty Years of Experience 1 Female 42 Master’s Associate Chief Physician Clinical Medicine 18 2 Male 44 Master’s Associate Chief Physician Clinical Medicine 20 3 Male 52 Bachelor’s Associate Chief Physician Clinical Medicine 29 4 Male 34 Doctorate Associate Chief Nurse Clinical Nursing 13 5 Female 42 Master’s Chief Nurse Clinical Nursing 23 6 Female 34 Bachelor’s Associate Chief Nurse Clinical Nursing 13 7 Male 38 Bachelor’s Associate Chief Nurse Clinical Nursing 16 8 Female 42 Bachelor’s Associate Chief Nurse Clinical Nursing 22 Expert Enthusiasm Coefficient The enthusiasm coefficient reflects the degree of active participation among experts, which directly influences the objectivity and reliability of the consultation outcomes. This coefficient was calculated as the proportion of participating experts to the total number invited. All eight experts completed the evaluation, yielding a 100% response rate and an enthusiasm coefficient of 1.0. Expert Authority Coefficient The authority coefficient (Cr) was determined by averaging the judgment basis score (Ca) and the familiarity score (Cs): A Cr value above 0.70 is considered indicative of reliable expert input. The results suggest that the panel possessed high authority in the field, and their recommendations were deemed credible. Self-assessment results of judgment basis and familiarity are shown in Tables 6 and 7. Table 6. Self-Evaluation of Judgment Basis by Experts Judgment Basis High n (%) Medium n (%) Low n (%) Practical experience 4 (50.00) 4 (50.00) 0 (0.00) Theoretical analysis 5 (62.50) 2 (25.00) 1 (12.50) Reference materials or peer input 4 (50.00) 3 (37.50) 1 (12.50) Intuitive judgment 3 (37.50) 4 (50.00) 1 (12.50) Table 7. Self-Evaluation of Familiarity with the Research Topic Familiarity Level n Very familiar 5 Relatively familiar 3 Moderately familiar 0 Not familiar 0 Very unfamiliar 0 Revisions Based on Expert Feedback During the expert panel meeting, several modifications were proposed and adopted to refine the attributes and levels for the follow-up needs of critically ill patients (Table 3-7). Key changes included:1）Adjusting follow-up duration categories to cover all possible timeframes;Specifying follow-up time intervals to exact hours;2）Removing items deemed outside the scope of follow-up (e.g., discharge procedures);3）Incorporating patient-centered assessment for supplemental services such as ICU memory retrieval to avoid psychological harm;4）Revising follow-up cost categories to be more comprehensive while retaining specific numeric values for willingness-to-pay analysis.The expert recommendations and revision summary are presented in Table 8. Table 8. Summary of Expert Recommendations and Revisions Expert Recommendation Revision Implemented Include all time ranges for follow-up duration Modified from “3, 6, 9, 12 months” to “≤3 months, 3–6 months, 6–12 months, ≥12 months” Specify follow-up time intervals by hour Changed from “morning, noon, afternoon” to “Morning: 06:00–10:00, Noon: 11:00–13:00, Afternoon: 14:00–18:00” Remove discharge procedure from information needs Deleted “discharge follow-up arrangements” from information needs ICU memory retrieval service should be based on patient needs and evaluation Added note to respect patient preferences and conduct appropriate assessments Ensure comprehensive coverage of follow-up costs Revised to “≤50 CNY, 50–100 CNY, >100 CNY” but retained numeric values (50, 100, 150 CNY) for willingness-to-pay analysis Step 4:Focus groups In the context of the experiment [34], while there is no universally accepted threshold for the number of attributes, prior systematic reviews indicate that the majority of studies typically encompass between 2 and 12 attributes [35]. Hiligman et al. suggest that a straightforward ranking exercise may suffice to fulfill this requirement [36]. Nonetheless, they emphasize the necessity for qualitative reasoning to ensure the pertinence of both the attributes and their corresponding levels. This assertion is corroborated by the findings of the present study, which revealed that among the seven attributes ultimately selected, the "cost" attribute did not receive a high ranking. However, based on qualitative analysis outcomes, the expert panel opted to retain the cost attribute. This decision is particularly relevant in the context of China's medical insurance system, which imposes limitations on the reimbursement of medical services. Consequently, patients often incur substantial out-of-pocket expenses, thereby exacerbating their long-term financial burden. Moving forward, the "cost" attribute is anticipated to yield valuable empirical data that can assist medical decision-makers in advocating for an increase in the proportion of medical services covered by insurance. This investigation presents numerous benefits. To begin with, it illustrated a rigorous and methodical approach to executing and documenting the process of extracting attributes and levels. Such an approach enhances transparency and facilitates reproducibility. Additionally, our research employed a hybrid methodology to formulate attributes and hierarchical structures. Each of the three employed techniques possesses distinct strengths and weaknesses, which serve to enhance one another. Notably, the qualitative data analysis has resulted in a more profound and comprehensive insight into the attributes and levels. Conversely, this investigation is not without its limitations. Firstly, the cohort for this study was exclusively comprised of critically ill patients who had been discharged from a single hospital in Guizhou, China, thereby potentially limiting its generalizability to other patient populations within the country. Variations in the accessibility of follow-up experiences and preferences may exist in different locales. Furthermore, Regional disparities in patients' educational attainment and income levels may influence their preferences and priorities regarding post-discharge follow-up care. In this study, the majority of respondents held secondary or lower education levels. This contrasts with previous multi-center studies on gastric cancer follow-up that primarily involved participants with high school education[37]. Additionally, when compared to more affluent cities in southern China, patients from Northeast China typically exhibit lower per capita household incomes and may be less likely to pursue outpatient follow-up due to the burden of additional travel and accommodation expenses. Future research should aim to further validate the preferences of the Chinese population. Secondly, while we employed a targeted sampling approach to ensure a comprehensive understanding, it is possible that participants did not fully share their personal experiences, potentially leaving some inquiries unaddressed. Nevertheless, during the focus group discussions, the patients involved did not introduce any new attributes or levels. We included critically ill patients with a range of conditions, representing various disease types. For those patients experiencing more severe illness, we favor follow-up content. In the subsequent empirical study of Discrete Choice Experiments (DCE), it will be essential to perform a subgroup analysis on patients with different disease types, to investigate the variations in preferences regarding critical attributes of follow-up care, ultimately facilitating the development of tailored management strategies for follow-up.The voting results for attributes are shown in Table 9. Table 9. Attribute voting results Attribute Very Important n (%) Moderately Important n (%) Not Important n (%) Follow-up content 14 (87.50) 2 (12.50) 0 (0) Follow-up method 12 (75.00) 1 (6.25) 3 (18.75) Out-of-pocket cost (CNY/visit) 11 (68.75) 3 (18.75) 2 (12.50) Follow-up model 10 (62.50) 5 (31.25) 1 (6.25) Follow-up personnel 9 (56.25) 3 (18.75) 4 (25.00) Follow-up frequency 8 (50.00) 6 (37.50) 2 (12.50) Duration 7 (43.75) 3 (18.75) 6 (37.50) Communication time 4 (25.00) 5 (31.25) 7 (43.75) Time of day for follow-up 3 (18.75) 4 (25.00) 9 (56.25) Follow-up location 2 (12.50) 5 (31.25) 9 (56.25) Additional service (ICU memory retrieval) 0 (0) 1 (6.25) 15 (93.75) Final Selection of Attributes and Levels In this study, the selection of attributes for the discrete choice experiment (DCE) was informed by both the results of the expert importance rating exercise and methodological recommendations from the literature. As shown in Table 3-X, experts rated “follow-up content” (87.50%), “follow-up method” (75.00%), and “cost” (68.75%) as the top three “very important” attributes, followed by “follow-up model” (62.50%), “follow-up personnel” (56.25%), “follow-up frequency” (50.00%), and “duration” (43.75%). Attributes with low importance ratings—such as “follow-up time of day” and “location”—were excluded to minimize cognitive burden on respondents. Previous research has suggested that the number of attributes in a DCE should be fewer than 10 to reduce respondent fatigue[38], with most studies including 4–8 attributes[39] and some recommending six as optimal[40]. Balancing methodological guidance with the expert panel results, we ultimately retained seven attributes: follow-up content, follow-up method, follow-up frequency, follow-up personnel, follow-up model, duration, and cost.The detailed definitions and levels for these attributes are provided in Table 10. Table 10 shows the voting results of attributes Attribute Definition Levels Follow-up content The topics covered by professionals during follow-up Care guidance and support; Information needs; Psychosocial support Follow-up method The method used by professionals to conduct follow-up after patient discharge Outpatient visit; Telephone; Online; Home visit Follow-up frequency Number of follow-up sessions per unit time Once per week; Once per month; Once every three months Follow-up personnel The professionals providing follow-up ICU physician; ICU nurse; Multidisciplinary team Follow-up model The format of the follow-up One-on-one follow-up; Follow-up with family participation Duration The length of time that professional follow-up is provided after discharge ≤3 months; 3–6 months; 6–12 months; ≥12 months Cost Out-of-pocket cost per single follow-up session 50 CNY; 100 CNY; 150 CNY Descriptions of Follow-up Content Care guidance and support includes: (1) how to contact local healthcare services; (2) guidance for handling emergencies; (3) instructions on monitoring changes in health status; (4) rehabilitation exercise guidance; (5) dietary advice; (6) home environment modification to promote mobility and prevent falls or bed-related injuries; (7) guidance on care for medical tubes (e.g., feeding tube, urinary catheter, drainage tube); (8) respiratory management (e.g., effective sputum clearance, tracheostomy care); (9) wound care (e.g., pressure ulcers, stoma care); (10) coping strategies for cognitive issues such as memory loss, reduced learning ability, and poor concentration. Information needs include: (1) understanding current health status and prognosis; (2) information on rehabilitation and treatment; (3) lifestyle and recovery precautions; (4) possible home-care challenges; (5) updates on disease-related advancements (e.g., new treatments, rehabilitation techniques, medications); (6) required home equipment and supplies and how to obtain them (e.g., oxygen concentrator, nebulizer, disinfectants); (7) potential effects of illness and treatment on work or study; (8) follow-up procedures. Psychosocial support includes: (1) alleviating negative emotions (e.g., anxiety, depression, tension, fear) related to ICU stay; (2) maintaining a positive outlook; (3) improving communication with family; (4) adapting to changes in family roles; (5) sustaining family support; (6) obtaining financial assistance or welfare benefits; (7) facilitating flexible arrangements from employers or colleagues. Definition of Multidisciplinary Team A multidisciplinary team refers to a group composed of physicians, nurses, rehabilitation therapists, psychologists, and dietitians. Conclusions This research enhances the literature on Discrete Choice Experiments (DCE) by meticulously detailing the methodology employed for the development of attributes and the selection of levels. Furthermore, the study highlights the relevance and strengths of the hybrid mixed-methods approach utilized. The success of a DCE largely depends on the researchers’ expertise in accurately identifying and refining relevant attributes and their corresponding levels. Therefore, it is imperative that subsequent investigations place greater emphasis on thoroughly articulating this methodology, including transparent documentation of each analytical step. Such rigorous reporting not only improves the clarity and reproducibility of the DCE design framework but also aids practitioners and researchers in evaluating the validity, quality, and adaptability of discrete choice experiments across various healthcare contexts. In this study, the iterative process of data analysis—spanning literature review, in-depth interviews, and focus group discussions—facilitated a comprehensive and patient-centered selection of attributes and levels. This approach ensured that the final discrete choice experiment is grounded in both empirical evidence and patient perspectives, thereby enhancing its relevance and applicability in real-world clinical decision-making. Declarations Ethics Approval and Consent to Participate Our research, which involved human participants and/or the utilization of human data or materials, was conducted in strict compliance with the Helsinki Declaration (https://www.wma.net/policies-post/wma-declaration-of-helsinki/). We hereby confirm that all ethical guidelines and principles outlined in the Declaration were adhered to throughout the study.Approved by the Ethics Committee of [Affiliated Hospital of Zunyi Medical University], approval number KLLY-2022-034. Written informed consent was obtained from all participants. Consent for Publication All authors have given their consent for the publication of this manuscript.All participants/patients involved in this study provided written informed consent for the publication of their personal or clinical details, as well as any identifying images, in the context of this research. A copy of the signed consent forms is available upon request. Availability of Supporting Data The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Conflict of Interest The authors declare that they have no conflict of interest. Funding This work was supported by the Guizhou Science and Technology Project (gzwkj2025-592). Author Contributions Conceptualization:Junlan Dong,Zhixia Jiang,,Linlin You,Xiaoli Yuan,Sijin Li,Juan Luo. Data curation:Junlan Dong, Zhixia Jiang, jinzhou, Linlin You, Sijin Li. Formal analysis:Junlan Dong,You,Sijin Li,Juan Luo. Funding acquisition:Junlan Dong, Zhixia Jiang, jinzhou, Xiaoli Yuan, Linlin You. Investigation:Junlan Dong, Xiaoli Yuan, Linlin You. Methodology:Junlan Dong, Zhixia Jiang, Sijin Li, Juan Luo. Project administration:Junlan Dong, Zhixia Jiang,jinzhou, Xiaoli Yuan,Linlin You,Sijin Li Resources:Junlan Dong, Zhixia Jiang, Linlin You. Supervision:Junlan Dong, Zhixia Jiang, jinzhou, Xiaoli Yuan,Linlin You. Validation:Junlan Dong Zhixia Jiang, jinzhou,Xiaoli Yuan,Linlin You,Sijin Li,Juan Luo. Visualization:Junlan Dong, Zhixia Jiang, Xiaoli Yuan, Linlin You, Sijin Li, Juan Luo. Writing – original draft:Junlan Dong, Linlin You. 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Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 18 Dec, 2025 Reviewers agreed at journal 02 Dec, 2025 Reviewers invited by journal 28 Nov, 2025 Editor assigned by journal 26 Nov, 2025 Editor invited by journal 04 Nov, 2025 Submission checks completed at journal 04 Nov, 2025 First submitted to journal 04 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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16:20:57","extension":"html","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":168173,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7911777/v1/14a97551710af45aa22ae8af.html"},{"id":97367294,"identity":"d0d59b04-2533-4253-95c9-0e5e1924b7f2","added_by":"auto","created_at":"2025-12-03 16:18:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":101899,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart selection process.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7911777/v1/be9edaf6ab1e0d0ed0855553.png"},{"id":97664522,"identity":"cfd66a81-5d72-417f-bce2-93b41113b9d1","added_by":"auto","created_at":"2025-12-08 09:08:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1194266,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7911777/v1/c3f649fa-3784-4062-92e0-a9ccf5d12b65.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Preferences of follow-up services patients with critically ill patients: Attributes development for a discrete choice experiment","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWith the development of critical care medicine, the number of patients admitted to intensive care units (ICUs) is increasing, and the survival rate of ICU patients has reached 90% [1\u0026ndash;2]. However, depending on age and severity of critical illness, mortality at 1 year after ICU discharge remains high, ranging from 10% to 30% [3\u0026ndash;5]. In addition, ICU patients often develop physical, psychological, and cognitive impairments classified as post-intensive care syndrome (PICS) [6\u0026ndash;7]. This syndrome is associated with heightened mortality rates, elevated rates of readmission, and challenges in reintegrating into societal roles or returning to the workforce, ultimately resulting in diminished health-related quality of life.\u003c/p\u003e\n\u003cp\u003eGiven the complexity of post-discharge needs\u0026mdash;combined with insufficient capacity of primary healthcare institutions, heavy family caregiving burden, and limited caregiver expertise\u0026mdash;home rehabilitation after ICU discharge faces substantial challenges. Scientific and effective follow-up care can improve patients\u0026rsquo; physical, psychological, cognitive, and social functioning, while reducing mortality and healthcare utilization [8].\u003c/p\u003e\n\u003cp\u003eHowever, patient compliance with follow-up care is shaped by multiple interrelated factors, including personnel type, delivery method, frequency, duration, content, and disease progression [9\u0026ndash;10]. These follow-up design decisions are preference-sensitive\u0026mdash;there is no single universally optimal choice, and the \u0026ldquo;best\u0026rdquo; plan depends on the individual patient\u0026rsquo;s values and priorities. This aligns with the principles of Patient-Centered Care (PCC), which emphasize tailoring healthcare to patient preferences, and Shared Decision-Making (SDM), which provides a structured approach for incorporating those preferences into clinical decisions.\u003c/p\u003e\n\u003cp\u003eThe Discrete Choice Experiment (DCE) is a robust stated-preference method that directly operationalizes PCC and SDM principles, allowing researchers to identify, quantify, and prioritize attributes of care from the patient\u0026rsquo;s perspective [11]. In recent years, DCEs have been widely applied to assess patient preferences in cancer follow-up care [12,13], demonstrating that such patient-centered strategies can improve compliance by 41%\u0026ndash;67% [14]. A systematic review also supports that patient-centered follow-up strategies enhance adherence and satisfaction [15].\u003c/p\u003e\n\u003cp\u003eEstablished methodological guidelines highlight the critical role of systematically developing and validating attributes and levels in DCEs [16\u0026ndash;17]. Yet, many studies merely outline their attribute identification methods without detailing a structured, theory-informed process [11,18]. Grounded in PCC and SDM, the present study aims to identify, refine, and select follow-up attributes and levels that reflect ICU patients\u0026rsquo; preferences, thereby providing an evidence-based foundation for designing patient-centered post-ICU follow-up programs.\u003c/p\u003e\n\u003cp\u003eTheoretical Framework\u003c/p\u003e\n\u003cp\u003eThis study was grounded in the Patient-Centered Care (PCC) framework and the principles of Shared Decision-Making (SDM). PCC emphasizes delivering healthcare that respects and responds to the preferences, needs, and values of individual patients, ensuring that these elements guide all clinical decisions. In the ICU discharge context, follow-up care design is inherently preference-sensitive\u0026mdash;multiple clinically appropriate options exist, and the optimal choice depends on the patient\u0026rsquo;s unique circumstances and priorities.\u003c/p\u003e\n\u003cp\u003eSDM complements PCC by offering a structured, collaborative process in which patients and clinicians jointly consider clinical evidence and personal values to arrive at informed decisions. The Discrete Choice Experiment (DCE) method was selected because it operationalizes these theoretical principles, enabling the systematic elicitation and quantification of patient preferences across multiple care attributes. Grounding the attribute development process in PCC and SDM ensured that the resulting follow-up framework was both scientifically rigorous and aligned with core principles of patient-centered care.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study adopted an exploratory sequential mixed-methods design in accordance with the framework proposed by Creswell and Plano Clark (2018). This design enables the rigorous integration of qualitative and quantitative data to comprehensively address the research questions related to ICU patient follow-up care preferences.\u003c/p\u003e\n\u003cp\u003eStudy design\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStep 1: Scoping Review\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe literature review in this study was conducted as a \u003cstrong\u003esystematic scoping review\u003c/strong\u003e in accordance with the \u003cstrong\u003eJoanna Briggs Institute (JBI) methodology for scoping reviews\u003c/strong\u003e and reported following the \u003cstrong\u003ePRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews)\u003c/strong\u003e checklist. This approach was selected to ensure methodological transparency and reproducibility.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Question\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhich attributes and levels of follow-up needs can be identified for ICU patients based on the existing literature?\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSearch Strategy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA comprehensive search was performed in \u003cstrong\u003eEmbase\u003c/strong\u003e, \u003cstrong\u003ePubMed\u003c/strong\u003e, \u003cstrong\u003eWeb of Science\u003c/strong\u003e, \u003cstrong\u003eChinese National Knowledge Infrastructure (CNKI)\u003c/strong\u003e, and \u003cstrong\u003eWanfang Database\u003c/strong\u003e, covering all available publications from database inception to May 2023. The search strategy was developed in consultation with an experienced medical librarian to maximize sensitivity and specificity.\u003c/p\u003e\n\u003cp\u003eKeywords were derived from a combination of \u003cstrong\u003eMedical Subject Headings (MeSH)\u003c/strong\u003e terms and free-text keywords. For example, in PubMed, MeSH terms included \u003cem\u003eCritical Illness\u003c/em\u003e, \u003cem\u003ePatient Compliance\u003c/em\u003e, and \u003cem\u003eContinuity of Patient Care\u003c/em\u003e. Free-text terms such as \u0026quot;follow-up,\u0026quot; \u0026quot;patient adherence,\u0026quot; and \u0026quot;patient preferences\u0026quot; were included to capture studies not yet indexed or lacking appropriate MeSH terms. For the Chinese databases (CNKI and Wanfang), equivalent controlled vocabulary and free-text terms were applied. When a keyword was not available in recognized thesauri, its inclusion was justified based on its frequent use in relevant prior studies and expert consensus. The complete search strings for each database are provided in \u003cstrong\u003eTable1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudies were included if they:\u003c/p\u003e\n\u003cp\u003e1.Focused on critically ill patients aged \u0026ge;18 years post-discharge from the ICU.\u003c/p\u003e\n\u003cp\u003e2.Addressed follow-up adherence, preferences, or experiences.\u003c/p\u003e\n\u003cp\u003eNo restrictions were applied to study design. Only English and Chinese publications were considered\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Selection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter duplicate removal, two reviewers independently screened titles and abstracts, followed by full-text assessment for eligibility. Disagreements were resolved through discussion, with a third reviewer acting as arbiter when consensus could not be reached.\u003c/p\u003e\n\u003cp\u003eQuality assessment (QA Score)In this study, the Quality Assessment (QA) score was calculated based on standardized critical appraisal tools appropriate for the study designs included. Specifically, tools such as the Joanna Briggs Institute (JBI) critical appraisal checklist [19] and the Cochrane Risk of Bias tool [20] were employed. Two independent reviewers assessed each study across multiple domains including study design, sample size adequacy, outcome measurement validity, and data analysis transparency. The scores from these domains were summed to generate an overall QA score, with higher scores indicating better methodological quality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Charting and Synthesis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwo reviewers independently extracted data on author, year, location, objective, study design, surgical intervention (if applicable), sample size, and identified attributes with their corresponding levels. Data were charted in a standardized extraction form adapted from the JBI template. Extracted data were collated, summarized, and presented in tabular and narrative form, resulting in a preliminary inventory of attributes and levels for subsequent phases of the study.\u003c/p\u003e\n\u003cp\u003eStep 2: In-depth interviews\u003c/p\u003e\n\u003cp\u003ePatient recruitment.\u003c/p\u003e\n\u003cp\u003eTo gather insights regarding the experiences and requirements of critically ill patients upon their discharge, we conducted a recruitment process targeting patients from the Intensive Care Unit (ICU) of a tertiary medical facility located in Zunyi City, spanning from October 2022 to December 2022. We implemented purposeful sampling techniques to ensure a comprehensive variation in the patient experiences. The inclusion criteria established were as follows: 1) Participants must be aged 18 years or older; 2) A minimum ICU stay of 48 hours, with mechanical ventilation for at least 24 hours; 3) Patients must be conscious and capable of communication at the time of transfer from the ICU. Individuals diagnosed with malignant tumors or those experiencing disorders of consciousness that hindered effective communication were excluded from the study. All participants provided written informed consent prior to their inclusion.\u003c/p\u003e\n\u003cp\u003eData collection\u003c/p\u003e\n\u003cp\u003eThe duration of each interview is approximately 30 to 60 minutes. Researchers contact the interviewees in advance to provide a detailed explanation of the purpose and significance of the interview. After obtaining their consent, researchers jointly determine the time and select an independent and quiet office as the location of the interview. Before starting the interview, researchers obtain the consent of the hospital ethics committee and sign an informed consent form with the interviewee. Based on the initial attributes and specific needs classification obtained from literature reviews, we developed a semi-structured interview outline focusing on themes related to individual follow-up experiences. The content specifically covers: 1) Follow-up perceptions and perspectives; 2) Factors affecting patient adherence to follow-up; 3) Post-discharge status and needs; 4) Post-discharge follow-up content and plans.The final interview guide was refined through the pilot interviews (see Table S2). Before the interview began, each patient completed a brief questionnaire on socio-demographic and clinical characteristics. All interviews were recorded with permission and transcribed verbatim. When no new attributes were identified, saturation was reached.\u003c/p\u003e\n\u003cp\u003eData analysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData collection and analysis occurred simultaneously, employing thematic analysis to interpret the transcripts [11]. In the first phase, codes and themes were derived from a predetermined list of attributes and their associated levels, which pertain to distinct characteristics and categories pertinent to the research. Following this, we conducted a review of the established codes and themes and generated\u003c/p\u003e\n\u003cp\u003eStep 3: Expert Panel Analysis\u003c/p\u003e\n\u003cp\u003eFollowing the identification of preliminary attributes and levels through literature review and semi-structured interviews, an expert panel meeting was convened to refine and validate these attributes. Given that including an excessive number of attributes can increase participant burden and complicate the discrete choice experiment (DCE) questionnaire, a range of 5 to 8 attributes was deemed appropriate to balance comprehensiveness and feasibility [21].\u003c/p\u003e\n\u003cp\u003eExpert Selection\u003c/p\u003e\n\u003cp\u003eThe expert panel was purposively sampled from clinical specialists in critical care within our institution. Selection criteria included:1)A minimum educational attainment of a bachelor\u0026rsquo;s degree or higher;2)Professional rank of associate senior level (equivalent to associate professor) or above;3)At least 10 years of relevant clinical experience;4)Active involvement in critical care, encompassing both physicians and clinical nurses;5)Voluntary consent to participate in the study.\u003c/p\u003e\n\u003cp\u003ePanel Procedures\u003c/p\u003e\n\u003cp\u003eThe panel\u0026rsquo;s objectives were to:1)Assess the appropriateness and relevance of the preliminary attributes and their specific items in capturing the follow-up needs and preferences of critically ill patients;2)Review and propose necessary modifications to the content and definitions of each attribute and its levels.\u003c/p\u003e\n\u003cp\u003eData Analysis\u003c/p\u003e\n\u003cp\u003eDescriptive statistics were calculated using SPSS 29.0. Continuous variables are presented as mean \u0026plusmn; standard deviation, and categorical variables as frequencies and percentages. Expert engagement was evaluated based on attendance rates and the extent of active feedback, with higher participation indicating greater expert involvement.\u003c/p\u003e\n\u003cp\u003eThe authority of expert judgments was quantified via the expert authority coefficient (Cr), calculated as the average of the judgment basis (Ca) and familiarity (Cs):\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"109\" height=\"37\" src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1764576234.jpg\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003eValues of Cr range from 0 to 1, where higher values denote stronger expert authority. A threshold of Cr \u0026ge; 0.7 was applied to indicate acceptable reliability of expert input.\u003c/p\u003e\n\u003cp\u003eStep 4: Focus groups\u003c/p\u003e\n\u003cp\u003eParticipants in the focus group provided insights through brief activities designed to validate and refine the attributes and levels identified during the in-depth interviews. The focus group sessions were conducted in a confidential area of the hospital and facilitated by an independent moderator supported by an assistant.\u003c/p\u003e\n\u003cp\u003eImportantly, the focus group participants were \u003cstrong\u003enot the same individuals who took part in the in-depth interviews\u003c/strong\u003e; instead, a purposive sampling method was used to recruit new participants who had been discharged from the intensive care unit in December 2022. These participants were organized into four distinct focus groups based on their ICU admission periods, with each group consisting of 4 to 5 members. The inclusion criteria for focus group participants were consistent with those used for the in-depth interviews to ensure comparability.\u003c/p\u003e\n\u003cp\u003eThe focus group discussions resulted in clarification and refinement of attribute terminology, improved understanding of patient perspectives, and a prioritization of attributes through a voting-based ranking process. These outcomes contributed to streamlining the preliminary list of attributes into a manageable and patient-relevant set for subsequent discrete choice experiment design.\u003c/p\u003e\n\u003cp\u003eThe activities conducted within the focus groups were systematically organized into three distinct phases. In the initial phase, participants assessed the significance of each attribute and level presented, relating them to their personal experiences. They were also encouraged to propose any additional attributes and levels that they deemed critical when considering options for Follow-up programme. Following this, a ranking exercise was performed to streamline the number of attributes to a more manageable set suitable for a Discrete Choice Experiment (DCE) [22]. Participants ranked the newly identified attributes, assigning points ranging from 3 for the most significant attribute to 1 for the least significant. Subsequently, the average importance score for each attribute was computed by dividing the aggregate points assigned to each attribute by the total number of participants from all focus groups [22]. Participants individually ranked the attributes according to their relevance, and the mean scores reflected the collective ranking of the group [23]. Utilizing these mean importance scores, we arranged the attributes from the most important (highest mean) to the least important (lowest mean). An excessive number of attributes has the potential to complicate the task for participants, which could result in inconsistent responses across different choice scenarios or lead to participants overlooking certain attributes during their decision-making process [24]. Consequently, in alignment with the preceding discrete choice experiment, we intend to incorporate the eight most significant attributes in our subsequent study [23]. Finally, a group discussion was convened to evaluate the patients\u0026apos; rankings as well as the phrasing of the attributes and levels. Both researchers and focus group participants scrutinized the clarity and consistency of the meanings and interpretations associated with the attributes. This group discussion persisted until all attributes and levels were thoroughly and explicitly articulated.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from participants at the beginning of the survey. Those participating in face-to-face interviews provided written consent, while participants in telephone interviews gave verbal consent, which was documented by the interviewer, as written consent was not obtainable. This consent procedure was approved by the ethics committee.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eStep 1: A literature review\u003c/p\u003e\n\u003cp\u003eThe literature search resulted in a total of 1,178 publications (PubMed: n = 586; Embase: n = 182; Web of Science: n = 293; CNKI: n = 12; Wanfang: n = 105). Following the elimination of 360 duplicate entries, 818 records were retained for the eligibility assessment. Initial screening conducted through titles and abstracts led to the exclusion of 768 articles. Subsequently, 50 articles were thoroughly reviewed for eligibility, and 28 of these were further excluded. In the end, eight studies satisfied our predetermined inclusion criteria [25-32]. The selection process is visually summarized in Figure 1. The characteristics of the included studies are detailed in Table 1. From the data analysis, our research team reviewed the attributes and levels derived from the literature review, ultimately identifying 13 distinct attributes. Its related attributes and levels are presented in Table 2.However, due to the absence of specific values related to the cost attribute in the literature, we were unable to conduct a level analysis for this particular attribute.\u003c/p\u003e\n\u003cp\u003eTable 1. Study characteristics.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\" width=\"941\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eStudy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eObjective\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eStudy design\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003eQA score\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eSample size(n)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eAttributes(levels)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eEngstromet al. [25]\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(2008)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eTo describe how ICU survivors and\u0026nbsp;\u003c/p\u003e\n \u003cp\u003efamilies experience a post-discharge,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003efollow-up visit to the ICU.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eSweden\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eQualitative study\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e8/10 (80%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eGain strength from being back together; gain understanding of the experience of a critically ill patient; gain gratitude for surviving; and gain possibilities for improved care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eChatzaki 2012[26]\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eTo defifine families\u0026rsquo; needs, using the\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCritical Care Family Needs Inventory\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(CCFNI), in Crete, Greece.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eGreece\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eCross-sectional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003estudy\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e7/8 (87.5%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 230\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eRegardless of participants\u0026apos; backgrounds, ensure that needs projects are consistently selected as the most important. Participants with lower educational and socioeconomic status will support needs projects to be rated as more important than those with higher status.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eCzerwonka\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eet al. [27]\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(2015)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eA pilot study to explore survivors\u0026rsquo; and families\u0026rsquo; needs throughout the recovery continuum using the Timing it Right\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eframework.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eFramework\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMethodology\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e8/10 (80%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eThe study identified a central theme: survivors undergoing critical illness rehabilitation often lack sustained medical care. Three subthemes highlight key aspects: (1) Information needs evolve throughout the nursing process, (2) Fear and anxiety emerge when families remain uncertain about outcomes, and (3) Survivors transition from dependency to independence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eSchofield-Robinson\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e[28] (2018)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eobjective was to assess the effectiveness of follow-up services aimed at identifying and addressing the unmet health needs of ICU survivors following their ICU stay.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003e\u0026nbsp;England\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eNon-experimental observational study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003cp\u003e（70%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN=1707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eType of lead provider: Nurse-led vs. multidisciplinary team\u003c/p\u003e\n \u003cp\u003eMode of delivery: Face-to-face vs. telephone consultations\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFrequency: Weekly, monthly, every six months, or up to eight sessions\u003c/p\u003e\n \u003cp\u003eTiming and duration of follow-up varied across studies\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eVan Sleeuwen 2020[29]\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eTo explore health issues in families of intensive care survivors and the\u0026nbsp;\u003c/p\u003e\n \u003cp\u003econsequences for their daily lives\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eNetherlands\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eThematic Analysis\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e8/10 (80%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 13\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eThe issues addressed are categorized into six themes: (1) Physical functions (e.g., fatigue, headaches, and increased discomfort); (2) Mental health (e.g., anxiety, heightened stress, and difficulty expressing emotions); (3) Survival aspects and future concerns (e.g., uncertainty about the future); (4) Quality of life (e.g., loss of personal freedom); (5) Relationships and social engagement (e.g., experiencing lack of understanding); (6) Daily functioning (e.g., cessation of work).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eTate 2020[30]\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eTo explore positive experiences of caring for an intensve care survivor and describe factors viewed as important for a positive\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eexperience\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eContent Analysis\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003e10/10\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 41\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003eDuring the hospital stay, caregivers described how their roles shifted, with their primary responsibility shifting to defending the patient. They explained how this experience fulfilled their identity and strengthened their bond with the patient. Most family caregivers emphasized the importance of social support and prayer.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eHajalizadeh(2021)[31]\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eThis study aimed to determine the informational needs of families of patients discharged from Intensive Care Units (ICU), Kerman, southeast Iran.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eKerman, southeast Iran\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003ea cross-sectional design\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN=140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003ethe maximum need was associated with self-care subscale (4.89 out of 5), and the minimum need was associated with defecation (3.13 out of 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 15.6217%;\"\u003e\n \u003cp\u003eClarke R.[32] (2022)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5399%;\"\u003e\n \u003cp\u003eThe aim of the service evaluation was to generate knowledge on experiences of psychological and physical rehabilitation in intensive care, on other hospital wards and at home to inform the development of an Intensive Care follow up clinic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.24548%;\"\u003e\n \u003cp\u003eBritain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3464%;\"\u003e\n \u003cp\u003eContent Analysis\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.54516%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.77683%;\"\u003e\n \u003cp\u003eN = 20\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30.9245%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eThemes\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e：\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSense making difficulties\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRehabilitation context\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSense of self\u003c/strong\u003e （自我感知）\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eSub-themes\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e：\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSense making difficulties\u003c/strong\u003e：memory gaps、delirium、lack of information、anxiety\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRehabilitation context\u003c/strong\u003e：ICU environment、transitions、isolation and abandonment、valued support\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Initial attributes and levels obtained from the literature review.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003eSerial number\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eAttributes\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003cp\u003eLevels\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eFollow-up content\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003eCare guidance and support\u003c/li\u003e\n \u003cli\u003einformation requirements\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePsychosocial support\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eFollow-up route\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003esection for outpatients\u003c/li\u003e\n \u003cli\u003eTelephone\u003c/li\u003e\n \u003cli\u003eNetwork\u003c/li\u003e\n \u003cli\u003eHome follow-up\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003efrequency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003eonce a week\u003c/li\u003e\n \u003cli\u003eonce every month\u003c/li\u003e\n \u003cli\u003eOnce every three months\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eFollow-up time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003cp\u003e1.5-10min\u003c/p\u003e\n \u003cp\u003e2.11-30min\u003c/p\u003e\n \u003cp\u003e3.＞30min\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003col\u003e\n \u003cli\u003eFollow-up provider\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eICU Doctor\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eICU nurse\u003c/li\u003e\n \u003cli\u003eMultidisciplinary team\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eFollow-up mode\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003eFollow up alone\u003c/li\u003e\n \u003cli\u003eParticipate with family\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eduration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003e3 months\u003c/li\u003e\n \u003cli\u003e6 months\u003c/li\u003e\n \u003cli\u003e12 months\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003ecost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003eplace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003eVisiting Hospital\u003c/li\u003e\n \u003cli\u003eCommunity Hospital\u003c/li\u003e\n \u003cli\u003eHome\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003etime quantum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003emorning\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAfternoon\u003c/li\u003e\n \u003cli\u003eEvening\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3199%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.1318%;\"\u003e\n \u003cp\u003ePrimary supplementary service (memory retrieval)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52.5483%;\"\u003e\n \u003col\u003e\n \u003cli\u003eNeed\u003c/li\u003e\n \u003cli\u003eNot need\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Step 2: In-depth interviews\u003c/p\u003e\n\u003cp\u003eDevelopment of the interview and focus group guides: The semi-structured interview guide used to identify attributes for the discrete choice experiment (DCE) was adapted from a protocol published by Lee et al. [33] in their study on oral nutritional supplement preferences among gastric cancer patients (Reference: Journal of Human Nutrition and Dietetics, 35(4), 678\u0026ndash;686). Minor modifications were made to align with the acute postoperative context of our study, including the addition of questions on Added Questions:Follow-up content specificity (e.g., \u0026quot;How acceptable is a weekly follow-up schedule \u0026nbsp;in the first month after leave hospital?\u0026quot;)Follow-up duration preferences (e.g., \u0026quot;Would you prefer a short-term follow-up (\u0026le;1 month) or a long-term follow-up (\u0026gt;3 months) for after leave hospital guidance?\u0026quot;).Removed Content:Sections on long-term cost-effectiveness analysis for chronic disease management were excluded.Focus group implementation: The adapted guide informed both the in-depth interviews and subsequent focus group discussions. Participants in the focus group provided insights through brief activities (e.g., ranking exercises, scenario-based discussions) to validate and refine the attributes and levels identified during the interviews. Sessions were conducted in a confidential hospital area by an independent moderator trained in qualitative research, supported by an assistant for note-taking and logistics.\u003c/p\u003e\n\u003cp\u003eDescription of the sample\u003c/p\u003e\n\u003cp\u003eA total of 14 patients transferred from the ICU were interviewed in this study, and the 14 interviewees were numbered as N1~N14 respectively. Table 3 displays the socio-demographic and clinical characteristics of the patients. Through these interviews, three new attributes were identified: \u0026quot;cost,\u0026quot; \u0026quot;ICU memory compensation,\u0026quot; and \u0026quot;follow-up subject selection.\u0026quot; Participants indicated that considering paying a certain fee during follow-up was also an important factor in their decision to continue long-term follow-up.The attributes and hierarchy extracted from the in-depth interviews are shown in Table 4\u003c/p\u003e\n\u003cp\u003eTable 3. Sociodemographic and Clinical Characteristics of ICU Participants (n = 14)\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eID\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eDiagnosis \u003cem\u003e(ICD-10)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003eICU Stay Duration (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eAcute suppurative cholangitis \u003cem\u003e(K83.0)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eSeptic shock \u003cem\u003e(R57.2)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eMultiple injuries \u003cem\u003e(T07)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eGastrointestinal perforation \u003cem\u003e(K63.1 / K31.5)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eRuptured anterior communicating artery aneurysm with hemorrhage \u003cem\u003e(I67.1)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eIntestinal obstruction \u003cem\u003e(K56.6)\u003c/em\u003e, peritonitis \u003cem\u003e(K65.0)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eRenal dysfunction \u003cem\u003e(N28.9)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003ePulmonary infection \u003cem\u003e(J18.9)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eDiabetic ketoacidosis \u003cem\u003e(E10.1 / E11.1)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eAcute respiratory failure \u003cem\u003e(J96.0)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eAcute liver failure \u003cem\u003e(K72.0)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eCOVID-19 \u003cem\u003e(U07.1)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eJunior High\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003ePulmonary infection \u003cem\u003e(J18.9)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 8.60927%;\"\u003e\n \u003cp\u003eN14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4305%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.755%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8874%;\"\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.7285%;\"\u003e\n \u003cp\u003eFreelancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.5099%;\"\u003e\n \u003cp\u003eGastrointestinal perforation \u003cem\u003e(K63.1 / K31.5)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13.0795%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 4. Included attributes and levels from in-depth interviews\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"661\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eAttributes\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003eLevels\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003eQuote excerpted from transcribed interviews\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eFollow-up content\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.Care guidance and support\u003c/p\u003e\n \u003cp\u003e2.information requirements\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.Psychosocial support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;After discharge, I need some support, such as guidance on diet and rehabilitation exercises.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I want to know the precautions after discharge, such as what can be done and what cannot be done.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I feel that after being hospitalized, my mood is always very low and I need medical staff to communicate with me emotionally to make me feel at ease.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eFollow-up method\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.via outpatients\u003c/p\u003e\n \u003cp\u003e2.via Telephone\u003c/p\u003e\n \u003cp\u003e3.via Network\u003c/p\u003e\n \u003cp\u003e4.via Home follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I think for me, making a phone call is the most convenient and communicating through the phone is the most suitable.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I would prefer to choose medical staff to communicate with me face-to-face so that I can detect changes in my condition.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;It would be great if medical staff could come and guide me on the care of my stoma and the precautions for peritoneal dialysis, even if I paid a certain fee. It would be inconvenient to go to the hospital\u0026rdquo;.\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;If the hospital has a WeChat account, our patients and family members can communicate and communicate through WeChat, which can better provide us with guidance on health.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eFollow-up provider\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003col\u003e\n \u003cli\u003eICU nurse\u003c/li\u003e\n \u003cli\u003eICU doctor\u003c/li\u003e\n \u003cli\u003eMultidisciplinary team\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I hope to be followed up by the supervising doctor of the ICU, as I have a good understanding of my condition and can rest assured of future consultations.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I think my bed nurse in the ICU has the most contact with me. I think she is very kind and patient with me. If she were to follow me up after discharge, it would be great.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I also have rehabilitation therapists in the ICU for rehabilitation training. I hope they can guide my recovery after discharge, and the doctors can provide guidance on my condition.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eFollow-up mode\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.Follow up alone\u003c/p\u003e\n \u003cp\u003e2.Participate with family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I think it\u0026apos;s enough to communicate with me for follow-up guidance after discharge, and I don\u0026apos;t want my family to be involved to avoid their concerns.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;After discharge, please contact my husband. I dare not face the prognosis after discharge. You can contact him and let him talk to me.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eDuration of follow\u003c/p\u003e\n \u003cp\u003eup\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.3 months\u003c/p\u003e\n \u003cp\u003e2.6 months\u003c/p\u003e\n \u003cp\u003e3.12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I think it\u0026apos;s okay to communicate with me once or twice a month, but the situation in the later stage will also be adjusted according to the changes in the condition. Of course, once it\u0026apos;s okay and cured, I think there\u0026apos;s no need to communicate.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;Just three months before discharge, you can contact me more frequently. Of course, I hope the hospital\u0026apos;s care for me can last for six months or even a year. It\u0026apos;s always good to call and care when you have time.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003ecost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;If I can meet my needs after discharge, I don\u0026apos;t have to go to the hospital frequently. I can accept paying a certain fee appropriately.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I feel very helpless after being discharged from the hospital. I have many questions but I don\u0026apos;t know who to ask. If the hospital can provide us with these help, I think I can accept paying fees below 100 yuan.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003ePlace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.Visiting Hospital\u003c/p\u003e\n \u003cp\u003e2.Community Hospital\u003c/p\u003e\n \u003cp\u003e3.Home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;Of course, it would be very convenient for me if medical staff could come home to provide me with prognosis guidance and follow-up.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;Since I am not local to Zunyi, it is not realistic for me to come to the hospital for follow-up treatment. The round-trip fare is only a few hundred yuan, as well as accommodation costs. I would rather choose our local community hospital, which is close to home, as they may not be very familiar with my condition.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;My family lives in Huichuan District, and it\u0026apos;s also convenient to come to the hospital. I prefer to come to the hospital to communicate with the doctors face-to-face, and I always feel more at ease.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003etime quantum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003col\u003e\n \u003cli\u003eMorning\u003c/li\u003e\n \u003cli\u003eAfternoon\u003c/li\u003e\n \u003cli\u003eEvening\u003c/li\u003e\n \u003c/ol\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;For time selection, I think it\u0026apos;s okay, but it might be better in the morning, with more energy, and I can better follow the guidance.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I tend to work at night and during the day, and I don\u0026apos;t want my mood to be affected by medical guidance.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003ePrimary supplementary service (memory retrieval)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003col\u003e\n \u003cli\u003eHave\u003c/li\u003e\n \u003cli\u003eNot have\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I have no idea about my hospitalization experience in the ICU. When I entered, I was in a coma, and I don\u0026apos;t want to recall that memory now. I don\u0026apos;t know, it\u0026apos;s great.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I am in a semi conscious and semi unconscious state inside, and I am not very clear about what I experienced. I just feel my hands and feet tied up, and I am actually quite curious about that experience.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003efrequency\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.once a week\u003c/p\u003e\n \u003cp\u003e2.once every month\u003c/p\u003e\n \u003cp\u003e3.Once every three months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I hope to provide regular assistance, preferably 2-3 times a month or once a week, for guidance.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I hope the hospital will communicate and guide us at least once a month.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I think I am in good condition, but I don\u0026apos;t need to contact too frequently. Just communicate and consult once every two to three months.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.0877%;\"\u003e\n \u003cp\u003eFollow-up time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.1649%;\"\u003e\n \u003cp\u003e1.5-10min\u003c/p\u003e\n \u003cp\u003e2.11-30min\u003c/p\u003e\n \u003cp\u003e3.＞30min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 46.7474%;\"\u003e\n \u003cp\u003e\u0026ldquo;I think time can be limited based on the prognosis. If there are many problems, more communication and consultation can be done, such as about half an hour. If there are few problems, a time period of 5-10 minutes can be sufficient.\u0026rdquo;\u003c/p\u003e\n \u003cp\u003e\u0026ldquo;I hope the hospital can help me for a longer time, patiently answer my questions, not just for completing tasks, but for genuinely caring about my condition and providing patient guidance.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Step 3: Expert Panel Analysis\u003c/p\u003e\n\u003cp\u003eA total of eight critical care experts with associate senior professional titles or above were included in the study. The panel comprised three physicians and five nurses, aged between 34 and 52 years, with professional experience ranging from 13 to 29 years. Educational backgrounds included one with a doctoral degree, three with master\u0026rsquo;s degrees, and four with bachelor\u0026rsquo;s degrees. Detailed characteristics are presented in Table 5.\u003c/p\u003e\n\u003cp\u003eTable5. Demographic and Professional Characteristics of Included Experts\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003eID\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eProfessional Title\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eSpecialty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003eYears of Experience\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Physician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Physician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Physician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eDoctorate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eMaster\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eChief Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.34921%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.2875%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.6984%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.2222%;\"\u003e\n \u003cp\u003eAssociate Chief Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3439%;\"\u003e\n \u003cp\u003eClinical Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.7549%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eExpert Enthusiasm Coefficient\u003c/p\u003e\n\u003cp\u003eThe enthusiasm coefficient reflects the degree of active participation among experts, which directly influences the objectivity and reliability of the consultation outcomes. This coefficient was calculated as the proportion of participating experts to the total number invited. All eight experts completed the evaluation, yielding a 100% response rate and an enthusiasm coefficient of 1.0.\u003c/p\u003e\n\u003cp\u003eExpert Authority Coefficient\u003c/p\u003e\n\u003cp\u003eThe authority coefficient (Cr) was determined by averaging the judgment basis score (Ca) and the familiarity score (Cs):\u003cimg width=\"199\" height=\"42\" src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1764576403.jpg\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003eA Cr value above 0.70 is considered indicative of reliable expert input. The results suggest that the panel possessed high authority in the field, and their recommendations were deemed credible. Self-assessment results of judgment basis and familiarity are shown in Tables 6 and 7.\u003c/p\u003e\n\u003cp\u003eTable 6. Self-Evaluation of Judgment Basis by Experts\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eJudgment Basis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eHigh n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eMedium n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eLow n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003ePractical experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e0 (0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eTheoretical analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e5 (62.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e2 (25.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eReference materials or peer input\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eIntuitive judgment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 7. Self-Evaluation of Familiarity with the Research Topic\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eFamiliarity Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eVery familiar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eRelatively familiar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eModerately familiar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eNot familiar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eVery unfamiliar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eRevisions Based on Expert Feedback\u003c/p\u003e\n\u003cp\u003eDuring the expert panel meeting, several modifications were proposed and adopted to refine the attributes and levels for the follow-up needs of critically ill patients (Table 3-7). Key changes included:1）Adjusting follow-up duration categories to cover all possible timeframes;Specifying follow-up time intervals to exact hours;2）Removing items deemed outside the scope of follow-up (e.g., discharge procedures);3）Incorporating patient-centered assessment for supplemental services such as ICU memory retrieval to avoid psychological harm;4）Revising follow-up cost categories to be more comprehensive while retaining specific numeric values for willingness-to-pay analysis.The expert recommendations and revision summary are presented in Table 8.\u003c/p\u003e\n\u003cp\u003eTable 8. Summary of Expert Recommendations and Revisions\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eExpert Recommendation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eRevision Implemented\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eInclude all time ranges for follow-up duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eModified from \u0026ldquo;3, 6, 9, 12 months\u0026rdquo; to \u0026ldquo;\u0026le;3 months, 3\u0026ndash;6 months, 6\u0026ndash;12 months, \u0026ge;12 months\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eSpecify follow-up time intervals by hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eChanged from \u0026ldquo;morning, noon, afternoon\u0026rdquo; to \u0026ldquo;Morning: 06:00\u0026ndash;10:00, Noon: 11:00\u0026ndash;13:00, Afternoon: 14:00\u0026ndash;18:00\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eRemove discharge procedure from information needs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eDeleted \u0026ldquo;discharge follow-up arrangements\u0026rdquo; from information needs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eICU memory retrieval service should be based on patient needs and evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eAdded note to respect patient preferences and conduct appropriate assessments\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eEnsure comprehensive coverage of follow-up costs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50%;\"\u003e\n \u003cp\u003eRevised to \u0026ldquo;\u0026le;50 CNY, 50\u0026ndash;100 CNY, \u0026gt;100 CNY\u0026rdquo; but retained numeric values (50, 100, 150 CNY) for willingness-to-pay analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Step 4:Focus groups\u003c/p\u003e\n\u003cp\u003eIn the context of the experiment [34], while there is no universally accepted threshold for the number of attributes, prior systematic reviews indicate that the majority of studies typically encompass between 2 and 12 attributes [35]. Hiligman et al. suggest that a straightforward ranking exercise may suffice to fulfill this requirement [36]. Nonetheless, they emphasize the necessity for qualitative reasoning to ensure the pertinence of both the attributes and their corresponding levels. This assertion is corroborated by the findings of the present study, which revealed that among the seven attributes ultimately selected, the \u0026quot;cost\u0026quot; attribute did not receive a high ranking. However, based on qualitative analysis outcomes, the expert panel opted to retain the cost attribute. This decision is particularly relevant in the context of China\u0026apos;s medical insurance system, which imposes limitations on the reimbursement of medical services. Consequently, patients often incur substantial out-of-pocket expenses, thereby exacerbating their long-term financial burden. Moving forward, the \u0026quot;cost\u0026quot; attribute is anticipated to yield valuable empirical data that can assist medical decision-makers in advocating for an increase in the proportion of medical services covered by insurance.\u003c/p\u003e\n\u003cp\u003eThis investigation presents numerous benefits. To begin with, it illustrated a rigorous and methodical approach to executing and documenting the process of extracting attributes and levels. Such an approach enhances transparency and facilitates reproducibility. Additionally, our research employed a hybrid methodology to formulate attributes and hierarchical structures. Each of the three employed techniques possesses distinct strengths and weaknesses, which serve to enhance one another. Notably, the qualitative data analysis has resulted in a more profound and comprehensive insight into the attributes and levels.\u003c/p\u003e\n\u003cp\u003eConversely, this investigation is not without its limitations. Firstly, the cohort for this study was exclusively comprised of critically ill patients who had been discharged from a single hospital in Guizhou, China, thereby potentially limiting its generalizability to other patient populations within the country. Variations in the accessibility of follow-up experiences and preferences may exist in different locales. Furthermore, Regional disparities in patients\u0026apos; educational attainment and income levels may influence their preferences and priorities regarding post-discharge follow-up care. In this study, the majority of respondents held secondary or lower education levels. This contrasts with previous multi-center studies on gastric cancer follow-up that primarily involved participants with high school education[37]. Additionally, when compared to more affluent cities in southern China, patients from Northeast China typically exhibit lower per capita household incomes and may be less likely to pursue outpatient follow-up due to the burden of additional travel and accommodation expenses. Future research should aim to further validate the preferences of the Chinese population.\u003c/p\u003e\n\u003cp\u003eSecondly, while we employed a targeted sampling approach to ensure a comprehensive understanding, it is possible that participants did not fully share their personal experiences, potentially leaving some inquiries unaddressed. Nevertheless, during the focus group discussions, the patients involved did not introduce any new attributes or levels. We included critically ill patients with a range of conditions, representing various disease types. For those patients experiencing more severe illness, we favor follow-up content. In the subsequent empirical study of Discrete Choice Experiments (DCE), it will be essential to perform a subgroup analysis on patients with different disease types, to investigate the variations in preferences regarding critical attributes of follow-up care, ultimately facilitating the development of tailored management strategies for follow-up.The voting results for attributes are shown in Table 9.\u003c/p\u003e\n\u003cp\u003eTable 9. Attribute voting results\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eAttribute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eVery Important n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eModerately Important n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eNot Important n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up content\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e14 (87.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e2 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e12 (75.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (6.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (18.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eOut-of-pocket cost (CNY/visit)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e11 (68.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (18.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e2 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e10 (62.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e5 (31.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (6.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up personnel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e9 (56.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (18.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (25.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up frequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e8 (50.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e6 (37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e2 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e7 (43.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (18.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e6 (37.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eCommunication time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (25.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e5 (31.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e7 (43.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eTime of day for follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e3 (18.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e4 (25.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e9 (56.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eFollow-up location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e2 (12.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e5 (31.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e9 (56.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003eAdditional service (ICU memory retrieval)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e1 (6.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25%;\"\u003e\n \u003cp\u003e15 (93.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFinal Selection of Attributes and Levels\u003c/p\u003e\n\u003cp\u003eIn this study, the selection of attributes for the discrete choice experiment (DCE) was informed by both the results of the expert importance rating exercise and methodological recommendations from the literature. As shown in Table 3-X, experts rated \u0026ldquo;follow-up content\u0026rdquo; (87.50%), \u0026ldquo;follow-up method\u0026rdquo; (75.00%), and \u0026ldquo;cost\u0026rdquo; (68.75%) as the top three \u0026ldquo;very important\u0026rdquo; attributes, followed by \u0026ldquo;follow-up model\u0026rdquo; (62.50%), \u0026ldquo;follow-up personnel\u0026rdquo; (56.25%), \u0026ldquo;follow-up frequency\u0026rdquo; (50.00%), and \u0026ldquo;duration\u0026rdquo; (43.75%). Attributes with low importance ratings\u0026mdash;such as \u0026ldquo;follow-up time of day\u0026rdquo; and \u0026ldquo;location\u0026rdquo;\u0026mdash;were excluded to minimize cognitive burden on respondents.\u003c/p\u003e\n\u003cp\u003ePrevious research has suggested that the number of attributes in a DCE should be fewer than 10 to reduce respondent fatigue[38], with most studies including 4\u0026ndash;8 attributes[39] and some recommending six as optimal[40]. Balancing methodological guidance with the expert panel results, we ultimately retained seven attributes: follow-up content, follow-up method, follow-up frequency, follow-up personnel, follow-up model, duration, and cost.The detailed definitions and levels for these attributes are provided in Table 10.\u003c/p\u003e\n\u003cp\u003eTable 10 shows the voting results of attributes\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eAttribute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eDefinition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eLevels\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up content\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eThe topics covered by professionals during follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eCare guidance and support; Information needs; Psychosocial support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eThe method used by professionals to conduct follow-up after patient discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eOutpatient visit; Telephone; Online; Home visit\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up frequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eNumber of follow-up sessions per unit time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eOnce per week; Once per month; Once every three months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up personnel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eThe professionals providing follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eICU physician; ICU nurse; Multidisciplinary team\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up model\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eThe format of the follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eOne-on-one follow-up; Follow-up with family participation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eThe length of time that professional follow-up is provided after discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u0026le;3 months; 3\u0026ndash;6 months; 6\u0026ndash;12 months; \u0026ge;12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eOut-of-pocket cost per single follow-up session\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e50 CNY; 100 CNY; 150 CNY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDescriptions of Follow-up Content\u003c/p\u003e\n\u003cp\u003eCare guidance and support includes: (1) how to contact local healthcare services; (2) guidance for handling emergencies; (3) instructions on monitoring changes in health status; (4) rehabilitation exercise guidance; (5) dietary advice; (6) home environment modification to promote mobility and prevent falls or bed-related injuries; (7) guidance on care for medical tubes (e.g., feeding tube, urinary catheter, drainage tube); (8) respiratory management (e.g., effective sputum clearance, tracheostomy care); (9) wound care (e.g., pressure ulcers, stoma care); (10) coping strategies for cognitive issues such as memory loss, reduced learning ability, and poor concentration.\u003c/p\u003e\n\u003cp\u003eInformation needs include: (1) understanding current health status and prognosis; (2) information on rehabilitation and treatment; (3) lifestyle and recovery precautions; (4) possible home-care challenges; (5) updates on disease-related advancements (e.g., new treatments, rehabilitation techniques, medications); (6) required home equipment and supplies and how to obtain them (e.g., oxygen concentrator, nebulizer, disinfectants); (7) potential effects of illness and treatment on work or study; (8) follow-up procedures.\u003c/p\u003e\n\u003cp\u003ePsychosocial support includes: (1) alleviating negative emotions (e.g., anxiety, depression, tension, fear) related to ICU stay; (2) maintaining a positive outlook; (3) improving communication with family; (4) adapting to changes in family roles; (5) sustaining family support; (6) obtaining financial assistance or welfare benefits; (7) facilitating flexible arrangements from employers or colleagues.\u003c/p\u003e\n\u003cp\u003eDefinition of Multidisciplinary Team\u003c/p\u003e\n\u003cp\u003eA multidisciplinary team refers to a group composed of physicians, nurses, rehabilitation therapists, psychologists, and dietitians.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis research enhances the literature on Discrete Choice Experiments (DCE) by meticulously detailing the methodology employed for the development of attributes and the selection of levels. Furthermore, the study highlights the relevance and strengths of the hybrid mixed-methods approach utilized. The success of a DCE largely depends on the researchers\u0026rsquo; expertise in accurately identifying and refining relevant attributes and their corresponding levels.\u003c/p\u003e\n\u003cp\u003eTherefore, it is imperative that subsequent investigations place greater emphasis on thoroughly articulating this methodology, including transparent documentation of each analytical step. Such rigorous reporting not only improves the clarity and reproducibility of the DCE design framework but also aids practitioners and researchers in evaluating the validity, quality, and adaptability of discrete choice experiments across various healthcare contexts.\u003c/p\u003e\n\u003cp\u003eIn this study, the iterative process of data analysis\u0026mdash;spanning literature review, in-depth interviews, and focus group discussions\u0026mdash;facilitated a comprehensive and patient-centered selection of attributes and levels. This approach ensured that the final discrete choice experiment is grounded in both empirical evidence and patient perspectives, thereby enhancing its relevance and applicability in real-world clinical decision-making.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur research, which involved human participants and/or the utilization of human data or materials, was conducted in strict compliance with the Helsinki Declaration (https://www.wma.net/policies-post/wma-declaration-of-helsinki/). We hereby confirm that all ethical guidelines and principles outlined in the Declaration were adhered to throughout the study.Approved by the Ethics Committee of [Affiliated Hospital of Zunyi Medical University], approval number KLLY-2022-034. Written informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have given their consent for the publication of this manuscript.All participants/patients involved in this study provided written informed consent for the publication of their personal or clinical details, as well as any identifying images, in the context of this research. A copy of the signed consent forms is available upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Supporting Data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Guizhou Science and Technology Project (gzwkj2025-592).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization:Junlan Dong,Zhixia Jiang,,Linlin You,Xiaoli Yuan,Sijin Li,Juan Luo.\u003c/p\u003e\n\u003cp\u003eData curation:Junlan Dong, Zhixia Jiang, jinzhou, Linlin You, Sijin Li.\u003c/p\u003e\n\u003cp\u003eFormal analysis:Junlan Dong,You,Sijin Li,Juan Luo.\u003c/p\u003e\n\u003cp\u003eFunding acquisition:Junlan Dong, Zhixia Jiang, jinzhou, Xiaoli Yuan, Linlin You.\u003c/p\u003e\n\u003cp\u003eInvestigation:Junlan Dong, Xiaoli Yuan, Linlin You.\u003c/p\u003e\n\u003cp\u003eMethodology:Junlan Dong, Zhixia Jiang, Sijin Li, Juan Luo.\u003c/p\u003e\n\u003cp\u003eProject administration:Junlan Dong, Zhixia Jiang,jinzhou, Xiaoli Yuan,Linlin You,Sijin Li\u003c/p\u003e\n\u003cp\u003eResources:Junlan Dong, Zhixia Jiang, Linlin You.\u003c/p\u003e\n\u003cp\u003eSupervision:Junlan Dong, Zhixia Jiang, jinzhou, Xiaoli Yuan,Linlin You.\u003c/p\u003e\n\u003cp\u003eValidation:Junlan Dong \u0026nbsp;Zhixia Jiang, jinzhou,Xiaoli Yuan,Linlin You,Sijin Li,Juan Luo.\u003c/p\u003e\n\u003cp\u003eVisualization:Junlan Dong, Zhixia Jiang, Xiaoli Yuan, Linlin You, Sijin Li, Juan Luo.\u003c/p\u003e\n\u003cp\u003eWriting \u0026ndash; original draft:Junlan Dong, Linlin You.\u003c/p\u003e\n\u003cp\u003eWriting \u0026ndash; review \u0026amp; editing:Junlan Dong, Zhixia Jiang, Xiaoli Yuan, Linlin You,Sijin Li, Juan Luo.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the medical workers and all the researchers involved in the study\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHu AP, Yang S, Ma YH, et al. 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Available at: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.gov.cn/zhengce/zhengceku/202305/content_6883704.htm?eqid=8a5dcca50002774700000003647db3bc\u003c/span\u003e\u003cspan address=\"https://www.gov.cn/zhengce/zhengceku/202305/content_6883704.htm?eqid=8a5dcca50002774700000003647db3bc\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Intensive care unit (ICU) patients, Post-discharge follow-up, Patient preferences, Discrete choice experiment, Mixed-methods study","lastPublishedDoi":"10.21203/rs.3.rs-7911777/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7911777/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eAdherence to follow-up services among intensive care unit (ICU) discharge patients is often low, contributing to poor prognosis. Understanding these patients\u0026rsquo; needs and preferences is essential for designing effective follow-up programs. The discrete choice experiment (DCE) offers a structured approach to quantifying such preferences, with the selection of attributes and levels being a critical step.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo describe the systematic process used to identify, refine, and finalize attributes and levels for a DCE on post-discharge follow-up care for ICU patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA mixed-methods approach was applied in three phases: (1) an extensive literature review to generate an initial pool of attributes and levels; (2) 16 in-depth interviews with former ICU patients to explore their experiences, needs, and expectations for follow-up care; (3)an expert panel meeting was convened to refine and validate these attributes and (4) Four focus groups were formed, each consisting of ICU survivors to clarify terminology, ensure patient-centered relevance, and prioritize attributes through a voting-based ranking process.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eSeven key attributes were finalized, each with two to four levels: follow-up content, route, frequency, personnel, mode, duration, and cost. These attributes reflect not only the logistical aspects of follow-up care but also the components most valued by patients for improving recovery and long-term health outcomes.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis mixed-methods strategy effectively integrated evidence, patient experience, and group consensus to generate attributes and levels that are both clinically relevant and patient-centered. The approach may serve as a model for other studies seeking to design DCEs in healthcare settings, ensuring that the attributes examined align closely with the priorities of the target population.\u003c/p\u003e","manuscriptTitle":"Preferences of follow-up services patients with critically ill patients: Attributes development for a discrete choice experiment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-02 14:33:26","doi":"10.21203/rs.3.rs-7911777/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-18T09:56:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"57785261445276988359426370799689905466","date":"2025-12-02T09:50:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-28T11:08:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-26T10:58:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-04T12:23:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-04T11:36:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-11-04T11:32:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c502f512-5776-44c2-bdbd-fc93c2ee7def","owner":[],"postedDate":"December 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-02T14:33:26+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-02 14:33:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7911777","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7911777","identity":"rs-7911777","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}