Shared decision making during surgical consultations: An observational study in pediatric otolaryngology.
Eur Ann Otorhinolaryngol Head Neck Dis
; 136(3S): S15-S19, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-30322709
ABSTRACT
AIMS:
Shared decision-making (SDM) is a collaborative process in which patients and family members make healthcare decisions together with their clinician. The objective of this study was to explore how pediatric otolaryngologists involve parents in SDM and which factors influence this process. MATERIAL ANDMETHODS:
Ninety-six children being assessed by pediatric otolaryngologists at a tertiary healthcare center for elective surgical procedures (adeno/tonsillectomy or tympanostomy tube insertion) were prospectively enrolled into the study. Surgical consultations were video-recorded and coded using the OPTION instrument to determine level of SDM. To provide a subjective measure of SDM, parents completed the Shared Decision-Making Questionnaire (SDM-Q-9) and surgeons completed the physician version of the questionnaire (SDM-Q-Doc).RESULTS:
Total mean child and parents OPTION scores were 3.16 (SD 5.43, range 0-21) and 11.38 (SD 6.41, range 1-27) out of 48 respectively. Clinicians were more likely to involve female children in SDM as well as children who had a previous history of surgery. There were no other significant correlations between total OPTION scores and patient/family demographics. A positive correlation was found between length of consultation and total OPTION scores for parents, but not for children. SDM-Q-9 and SDM-Q-Doc scores were not correlated with total OPTION scores.CONCLUSION:
Decision making during pediatric otolaryngology consultations mostly focused on treatment related decisions and sharing information as opposed to facilitating collaborative decision-making. Parent and physician perceptions of SDM were not correlated with actual observed behavior. Additional research is required to provide insight in how to increase surgeons' assistance towards SDM.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Otolaringologia
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Encaminhamento e Consulta
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Tonsilectomia
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Ventilação da Orelha Média
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Procedimentos Cirúrgicos Eletivos
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Tomada de Decisão Compartilhada
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article