Decision-making by parents and children in paediatric hand surgery

Bradbury, Eileen; Kay, Simon; Tighe, C.; Hewison, J.

doi:10.1016/0007-1226(94)90091-4

Cited by 36 publications

(25 citation statements)

References 2 publications

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“…62 Another approach to including children is asking for their opinion or for information that helps with parental decision making. 61 Although collaboration occurs less frequently with rapid decisions, 61 younger children, and sicker children, 50,61 parents often involve their child in end-of-life decisions. 32 Perhaps not surprisingly, although they often wanted to engage their child in the decision-making process, some parents report filtering the information provided to their child or trying to influence their child’s decision.…”

Section: Resultsmentioning

confidence: 99%

What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

Lipstein¹,

Brinkman

Britto³

2011

Med Decis Making

192

180

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Background With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process. Objective To conduct a narrative review of the current research on parent decision making about pediatric treatments and identify areas in need of further investigation. Methods Articles presenting original research on parent decision making were identified from MEDLINE (1966–6/2011), using the terms “decision making,” “parent,” and “child.” We included papers focused on treatment decisions but excluded those focused on information disclosure to children, vaccination, and research participation decisions. Results We found 55 papers describing 52 distinct studies, the majority being descriptive, qualitative studies of the decision-making process, with very limited assessment of decision outcomes. Although parents’ preferences for degree of participation in pediatric decision making vary, most are interested in sharing the decision with the provider. In addition to the provider, parents are influenced in their decision making by changes in their child’s health status, other community members, prior knowledge, and personal factors, such as emotions and faith. Parents struggle to balance these influences as well as to know when to include their child in decision making. Conclusions Current research demonstrates a diversity of influences on parent decision making and parent decision preferences; however, little is known about decision outcomes or interventions to improve outcomes. Further investigation, using prospective methods, is needed in order to understand how to support parents through the difficult treatment decisions.

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Section: Resultsmentioning

confidence: 99%

What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

Lipstein¹,

Brinkman

Britto³

2011

Med Decis Making

192

180

View full text Add to dashboard Cite

show abstract

“…There was heterogeneity among the studies in their risk of bias with studies scoring between 3 41 to 7 20 on the scale out of 9 stars. For selection bias, on a maximum of 4 stars, four studies had 2 stars, 31, 41, 55, 59 and eight studies had 3 stars 6, 20, 22, 30, 46, 56, 57, 60 . Only one study scored 2 stars 20 , and one scored one star 30 for comparability, as most of the studies did not have a comparison group.…”

mentioning

confidence: 99%

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

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Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.

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“…This information may include precise and accurate medical information of the underlying disease condition, the treatment options available, the benefits and side effects of these options, the expenses to be incurred by the parents, the treating doctor's experience with similar cases, and finally, the doctor's opinion on the choice of therapy that is preferred. 27 The study by van Dongen and Kaptein 6 showed that contrary to the belief that a chronic condition such as GH therapy warrants active involvement of the parents, their actual involvement in the decision-making process as perceived by them was in fact much lesser than optimal. Parents did not feel that they were involved in the process of making treatment decisions.…”

Section: Parent's Perspective Of the Doctor's Rolementioning

confidence: 98%

Shared decision making and patient choice for growth hormone therapy: current perspectives

George¹,

Ayyar²

2016

RRED

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Growth hormone has now been available in medical practice for close to 50 years. Its use has provided dramatic results in patients with growth hormone deficiency and it is associated with an overall favorable safety profile. Over the years, the utility of growth hormone has expanded to include treatment for short stature associated with conditions other than growth hormone deficiency, and this situation warrants greater involvement of the child and parents in the shared decision-making process. Shared decision making is in good conformance to the principle of informed consent, and it also improves the compliance and adherence to therapy as the patient fully understands the benefit and safety of the treatment. In the pediatric-care setting, the decision-making interactions usually occur between the health care provider, patient, and parents. The process may range from an autonomous decision-making pattern, where the patient or parents are fully responsible for the decision taken, to the paternalistic decision-making pattern, where the health care provider assumes full responsibility for the decision taken. However, the ideal situation is one where a truly shared decision-making process happens, in which the doctor and patient/parents work together to choose an evidence-based option, in line with the patient's preferences and wishes. The limited data available on shared decision making with regard to growth hormone replacement, however, is not very encouraging and suggests that the actual involvement of the parents as perceived by them is less than optimal. Introduction of a simple structured model for a shared decision-making process that can be easily incorporated into clinical practice and familiarization of health care providers with the same is essential to improve our shared decision-making practices.

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Decision-making by parents and children in paediatric hand surgery

Cited by 36 publications

References 2 publications

What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

Shared Decision Making and Choice for Elective Surgical Care

Shared decision making and patient choice for growth hormone therapy: current perspectives

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