“…This study was part of a larger mixed-methods research project examining shared decision-making in pediatric otolaryngology. The data on decision outcomes from the needs assessment sample have been previously reported [18]. …”
Section: Methodsmentioning
confidence: 99%
“…This manuscript outlines the initial phases of decision aid prototype development including 1) establishing a steering committee, 2) conducting a needs assessment, 3) designing the decision aid prototype, and 4) assessing the comprehensibility, feasibility and acceptability of the decision aid prototype, and modifying it accordingly.Fig. 1The International Patient Decision Aids Standards (IPDAS) frameworkSteering committeeParticipants in the steering committee included one fellowship trained pediatric otolaryngologist working in an academic tertiary care pediatric health centre with expertise in patient-centered care research, one child health psychologist with expertise in perioperative care, one cognitive psychologist with expertise in shared decision-making, two parents of children who previously had elective pediatric otolaryngology procedures, one nurse with expertise in patient-provider communication and shared decision-making, and one nurse research coordinator with expertise on perioperative care research.Needs assessmentParticipants in the needs assessment phase included 41 parents of children involved in the larger mixed-methods study (see Gorodzinsky et al [18] for demographics on the needs assessment sub-sample). Semi-structured interviews were conducted by telephone calls with parents two weeks after their child’s surgical consultation.…”
Section: Methodsmentioning
confidence: 99%
“…Interviews queried perceived need for decision support (including barriers and facilitators of decision-making), information perceived as important in decision-making, and preference for format of delivery of decision support. Qualitative thematic content analysis was used to summarize the results [18]. Videotapes of the surgical consultations with participants included in the larger study were also reviewed to identify the most common risks and benefits discussed.…”
BackgroundTo describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing.MethodsA paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and providers with qualitative content analysis of semi-structured interviews, which included open-ended user feedback.ResultsA steering committee composed of key stakeholders was assembled. A needs assessment was then performed, which confirmed the need for a decision support tool. A decision aid prototype was developed and modified based on semi-structured qualitative interviews and a scoping literature review. The prototype provided information on the condition, risk and benefits of treatments, and values clarification. The prototype underwent three cycles of accessibility, feasibility, and comprehensibility testing, incorporating feedback from all stakeholders to develop the final decision aid prototype.ConclusionA standardized, iterative methodology was used to develop a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. The decision aid prototype appeared feasible, acceptable and comprehensible, and may serve as an effective means of improving shared decision-making.
“…This study was part of a larger mixed-methods research project examining shared decision-making in pediatric otolaryngology. The data on decision outcomes from the needs assessment sample have been previously reported [18]. …”
Section: Methodsmentioning
confidence: 99%
“…This manuscript outlines the initial phases of decision aid prototype development including 1) establishing a steering committee, 2) conducting a needs assessment, 3) designing the decision aid prototype, and 4) assessing the comprehensibility, feasibility and acceptability of the decision aid prototype, and modifying it accordingly.Fig. 1The International Patient Decision Aids Standards (IPDAS) frameworkSteering committeeParticipants in the steering committee included one fellowship trained pediatric otolaryngologist working in an academic tertiary care pediatric health centre with expertise in patient-centered care research, one child health psychologist with expertise in perioperative care, one cognitive psychologist with expertise in shared decision-making, two parents of children who previously had elective pediatric otolaryngology procedures, one nurse with expertise in patient-provider communication and shared decision-making, and one nurse research coordinator with expertise on perioperative care research.Needs assessmentParticipants in the needs assessment phase included 41 parents of children involved in the larger mixed-methods study (see Gorodzinsky et al [18] for demographics on the needs assessment sub-sample). Semi-structured interviews were conducted by telephone calls with parents two weeks after their child’s surgical consultation.…”
Section: Methodsmentioning
confidence: 99%
“…Interviews queried perceived need for decision support (including barriers and facilitators of decision-making), information perceived as important in decision-making, and preference for format of delivery of decision support. Qualitative thematic content analysis was used to summarize the results [18]. Videotapes of the surgical consultations with participants included in the larger study were also reviewed to identify the most common risks and benefits discussed.…”
BackgroundTo describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing.MethodsA paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and providers with qualitative content analysis of semi-structured interviews, which included open-ended user feedback.ResultsA steering committee composed of key stakeholders was assembled. A needs assessment was then performed, which confirmed the need for a decision support tool. A decision aid prototype was developed and modified based on semi-structured qualitative interviews and a scoping literature review. The prototype provided information on the condition, risk and benefits of treatments, and values clarification. The prototype underwent three cycles of accessibility, feasibility, and comprehensibility testing, incorporating feedback from all stakeholders to develop the final decision aid prototype.ConclusionA standardized, iterative methodology was used to develop a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. The decision aid prototype appeared feasible, acceptable and comprehensible, and may serve as an effective means of improving shared decision-making.
“…In particular, they may seek advice or information from family members, other parents, their primary care providers, or the Internet. 6,20,21 All together, the implication is that parents are actively seeking more information beyond what was provided during consultation. Therefore, health care providers should consider developing educational tools with accurate information that can be provided for parents to review at home.…”
Section: Discussionmentioning
confidence: 99%
“…Unfortunately, research to date has shown that many patients have poor understanding of their medical conditions and treatments [4][5][6] and that recall of the information shared during consultation visits is inadequate. [5][6][7][8][9] Even after undergoing a detailed informed consent process, patients and family members have demonstrated poor recall of the risks discussed during surgical consultations. [9][10][11][12][13] Thus, a need exists to better understand the informed consent process in pediatric otolaryngology and determine what factors may influence recall of the information discussed during surgical consultations.…”
Parental recall of benefits and risks associated with common pediatric otolaryngology procedures was poor. This information is important because a low rate of recall may influence parents' perspectives of the procedure and could alter their decision-making processes or expectations. Methods to improve parental recall should be further studied.
IMPORTANCE Nasal airway obstruction (NAO) is a common problem that affects patient quality of life. Surgical success for NAO correction is variable. Virtual surgery planning via computational fluid dynamics (CFD) has the potential to improve the success rates of NAO surgery.OBJECTIVE To elicit surgeon feedback of a virtual surgery planning tool for NAO and to determine if this tool affects surgeon decision making.
DESIGN, SETTING, AND PARTICIPANTSFor this cross-sectional study, 60-minute face-to-face interviews with board-certified otolaryngologists were conducted at a single academic otolaryngology department from September 16, 2016, through October 7, 2016. Virtual surgery methods were introduced, and surgeons were able to interact with the virtual surgery planning tool interface. Surgeons were provided with a patient case of NAO, and open feedback of the platform was obtained, with emphasis on surgical decision making.
MAIN OUTCOMES AND MEASURESLikert scale responses and qualitative feedback were collected for the virtual surgery planning tool and its influence on surgeon decision making.RESULTS Our 9 study participants were all male, board-certified otolaryngologists with a mean (range) 15 (4-28) number of years in practice and a mean (range) number of nasal surgeries per month at 2.2 (0.0-6.0). When examined on a scale of 1 (not at all) to 5 (completely), surgeon mean (SD) score was 3.4 (0.5) for how realistic the virtual models were compared with actual surgery. On the same scale, when asked how much the virtual surgery planning tool changed surgeon decision making, mean (SD) score was 2.6 (1.6). On a scale of 1 (strongly disagree) to 7 (strongly agree), surgeon scores for perceived usefulness of the technology and attitude toward using it were 5.1 (1.1) and 5.7 (0.9), respectively.
CONCLUSIONS AND RELEVANCEOur study shows positive surgeon experience with a virtual surgery planning tool for NAO based on CFD simulations. Surgeons felt that future applications and areas of study of the virtual surgery planning tool include its potential role for patient counseling, selecting appropriate surgical candidates, and identifying which anatomical structures should be targeted for surgical correction.LEVEL OF EVIDENCE NA.
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