Parental decision making involvement and decisional conflict: a descriptive study

BMC Pediatrics

Research Article

Margaret L. Lawson¹  Anton Saarimaki²  Laura Boland³  Jennifer Kryworuchko⁴ 

[1] Family Decision Services, CHEO Research Institute, Children’s Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, K1H 8L1, Ottawa, ON, Canada;Ottawa Hospital Research Institute & University of Ottawa, 501 Smyth Road, Box 711, K2G 0Y1, Ottawa, ON, Canada;University of Ottawa, Faculty of Health Sciences, Population Health, 125 University Street, room 232, K1N 6N5, Ottawa, ON, Canada;University of Saskatchewan College of Nursing Health Sciences, E-4220, 104 Clinic Place, S7N 5E5, Saskatoon, SK, Canada;Present address: School of Nursing, University of British Columbia, Vancouver, Canada;

关键词: Pediatrics;    Parents;    Decisional conflict;    Shared decision making;    Family centered care;   

DOI  :  10.1186/s12887-017-0899-4

 received in 2015-08-28, accepted in 2017-06-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDecisional conflict is a state of uncertainty about the best treatment option among competing alternatives and is common among adult patients who are inadequately involved in the health decision making process. In pediatrics, research shows that many parents are insufficiently involved in decisions about their child’s health. However, little is known about parents’ experience of decisional conflict. We explored parents’ perceived decision making involvement and its association with parents’ decisional conflict.MethodWe conducted a descriptive survey study in a pediatric tertiary care hospital. Our survey was guided by validated decisional conflict screening items (i.e., the SURE test). We administered the survey to eligible parents after an ambulatory care or emergency department consultation for their child.ResultsFour hundred twenty-nine respondents were included in the analysis. Forty-eight percent of parents reported not being offered treatment options and 23% screened positive for decisional conflict. Parents who reported being offered options experienced less decisional conflict than parents who reported not being offered options (5% vs. 42%, p < 0.001). Further, parents with options were more likely to: feel sure about the decision (RR 1.08, 95% CI 1.02–1.15); understand the information (RR 1.92, 95% CI 1.63–2.28); be clear about the risks and benefits (RR 1.12, 95% CI 1.05–1.20); and, have sufficient support and advice to make a choice (RR 1.07, 95% CI 1.03–1.11).ConclusionMany parents in our sample experienced decisional conflict after their clinical consultation. Involving parents in the decision making process might reduce their risk of decisional conflict. Evidence based interventions that support parent decision making involvement, such as shared decision making, should be evaluated and implemented in pediatrics as a strategy to reduce parents’ decisional conflict.

【 授权许可】

CC BY   
© The Author(s). 2017