TY - JOUR
T1 - Parental role in decision-making for pediatric surgery
T2 - Perceptions of involvement in consultations for tonsillectomy
AU - Links, Anne R.
AU - Callon, Wynne
AU - Wasserman, Carly
AU - Walsh, Jonathan
AU - Tunkel, David E.
AU - Beach, Mary Catherine
AU - Boss, Emily F.
N1 - Funding Information:
This work was supported by the Agency for Healthcare Research and Quality ( AHRQ K08HS022932 ) and the American Society of Pediatric Otolaryngology Career Development Award . The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2020/5
Y1 - 2020/5
N2 - Objective: Parental role in decision-making has implications for quality of care. We describe roles of parent participation in decision-making for tonsillectomy. Methods: Parents reported preferred role in decision-making before consultations for tonsillectomy and the role they experienced after their consult. Parents completed questionnaires, including items evaluating clinician/parent communication. Clinicians rated perception of parents’ preferred role in decision-making. Congruence between parent and clinician responses was evaluated via kappa analysis. Logistic regression identified associations between decision-making roles and socioemotional and communication factors. Results: Consults between 63 parents and 8 otolaryngologists were analyzed.There was inadequate agreement between clinician and parent ratings of preferred roles (37%, p = 0.6, 95% CI [-0.09, 0.001]). Parents perceived greater involvement when clinicians discussed reasons to have (OR = 4.3, p = 0.03) or not have (OR = 4.1, p = 0.005) surgery. Parents perceived less involvement when clinicians used jargon (OR = 0.1, p = 0.03), and when parents trusted clinicians (OR = 0.4, p = 0.049), or experienced greater decisional conflict (OR = 0.9, p = 0.03). Conclusions: Parents and clinicians perceived parental preference for decision-making involvement differently during consultations for tonsillectomy. Clinician information-sharing, jargon use, and parent trust in clinician predicted extent of perceived engagement. Practice implications: Findings may enhance understanding of strategies to effectively communicate and engage parents in shared decision-making for pediatric surgical care.
AB - Objective: Parental role in decision-making has implications for quality of care. We describe roles of parent participation in decision-making for tonsillectomy. Methods: Parents reported preferred role in decision-making before consultations for tonsillectomy and the role they experienced after their consult. Parents completed questionnaires, including items evaluating clinician/parent communication. Clinicians rated perception of parents’ preferred role in decision-making. Congruence between parent and clinician responses was evaluated via kappa analysis. Logistic regression identified associations between decision-making roles and socioemotional and communication factors. Results: Consults between 63 parents and 8 otolaryngologists were analyzed.There was inadequate agreement between clinician and parent ratings of preferred roles (37%, p = 0.6, 95% CI [-0.09, 0.001]). Parents perceived greater involvement when clinicians discussed reasons to have (OR = 4.3, p = 0.03) or not have (OR = 4.1, p = 0.005) surgery. Parents perceived less involvement when clinicians used jargon (OR = 0.1, p = 0.03), and when parents trusted clinicians (OR = 0.4, p = 0.049), or experienced greater decisional conflict (OR = 0.9, p = 0.03). Conclusions: Parents and clinicians perceived parental preference for decision-making involvement differently during consultations for tonsillectomy. Clinician information-sharing, jargon use, and parent trust in clinician predicted extent of perceived engagement. Practice implications: Findings may enhance understanding of strategies to effectively communicate and engage parents in shared decision-making for pediatric surgical care.
KW - Clinician/patient relationship
KW - Communication
KW - Pediatrics
KW - Shared decision-making
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U2 - 10.1016/j.pec.2019.12.012
DO - 10.1016/j.pec.2019.12.012
M3 - Article
C2 - 31866196
AN - SCOPUS:85076853063
VL - 103
SP - 944
EP - 951
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 5
ER -