Shared Decision-Making in Pediatric Otolaryngology: Parent, Physician and Observational Perspectives

• Published in: International journal of pediatric otorhinolaryngology 2016-08, Vol.87, p.39-43
• Main Authors: Hong, Paul, Dr, Maguire, Erin, BSc, Gorodzinsky, Ayala Y., PhD, Curran, Janet A., PhD, Ritchie, Krista, PhD, Chorney, Jill, PhD
• Format: Article
• Language: English
• Subjects: Adenoidectomy; Adult; Child; Child, Preschool; Decision aids; Decision Making; Decisional conflict; Female; Humans; Infant; Informed consent; Male; Middle Aged; Middle Ear Ventilation; Otolaryngology; Parents - psychology; Patient Participation; Pediatric otolaryngology; Pediatrics; Perception; Physician-Patient Relations; Referral and Consultation; Shared decision-making; Surgeons - psychology; Surveys and Questionnaires; Tonsillectomy; Young Adult
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2016.05.031

Abstract Objective To describe physician and parent behavior during pediatric otolaryngology surgical consultations, and to assess whether perceptions of shared decision-making and observed behavior are related. Methods Parents of 126 children less than 6-years of age who underwent consultation for adeontonsillectomy or tympanostomy tube insertion were prospectively enrolled. Parents completed the Shared Decision-Making Questionnaire-Patient Version (SDM-Q-9), while surgeons completed the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) after the consultation. Visits were video-recorded and analyzed using the Roter Interaction Analysis System to quantify physician and parent involvement during the consultation. Results Perceptions of shared decision-making between parents (SDM-Q-9) and physicians (SDM-Q-Doc) were significantly positively correlated ( p = 0.03). However, there was no correlation between parents’ perceptions of shared decision-making and observations of physician and parent behavior/involvement (proportion of physician socioemotional talk, task-focused talk, or proportion of parent talk). Surgeons’ perceptions of shared decision-making were correlated with physician task-focused talk and proportion of parent talk. Conclusions Parents and physicians had similar perceptions of the degree of shared decision-making to be taking place during pediatric otolaryngology consultations. However, there was variability in the degree to which parents participated, and parent perceptions of shared decision-making were not correlated with actual observed involvement.