Relationship Between Parental Intolerance of Uncertainty and Decisional Conflict in Pediatric Otolaryngologic Surgery

Abstract

Objective To assess the relationship between depression, anxiety, stress, worry, intolerance of uncertainty (IU), and shared decision making (SDM) in parents of pediatric otolaryngology surgical patients with their perceptions of decisional conflict (DC). Study Design Cross-sectional. Setting Academic pediatric otolaryngology outpatient clinic. Methods Participants were legal guardians of pediatric patients who met criteria for otolaryngologic surgery. Participants completed a demographic survey as well as validated Decisional Conflict Scale (DCS); Shared Decision-Making Scale (SDMS); Depression, Anxiety and Stress Scale–21 (DASS-21); Penn State Worry Questionnaire (PSWQ); and short form of the Intolerance of Uncertainty Scale (IUS-12). Results A total of 114 participants were enrolled. Respondents were predominantly female (93.0%) and married (60.5%). Most guardians had not consented previously for otolaryngologic surgery for their child (69.3%). Participants reported low levels of DC and depression as well as moderate levels of anxiety and stress. DC scores were not significantly correlated to DASS-21, PSWQ, or SDM. IUS-12 Total and subscale IUS-12 prospective negatively correlated with Total DC. DC was not related to age, sex, education level, previous otolaryngologic surgery, or type of surgery recommended. Conclusion In this group, an association was found between IU and DC. Clinicians should be aware that DC is not modified by previous surgical experience. Interventions aimed at addressing parental IU related to surgery may reduce DC. Further research efforts could help us understand how mental health relates to surgical decision making.

Correlation Between Intolerance of Uncertainty and Post-Operative Regret in Otolaryngology Patients

“…A previous study in parents of pediatric otolaryngology patients suggested that there is a negative relationship between decisional conflict and IU, such that as IU increases DC will decrease. 28 IU may be an important predictor of decisionmaking difficulty and parental dissatisfaction in this group. It is important to note that IU is a modifiable psychologic construct.…”

Exploring Decisional Conflict With Measures of Numeracy and Optimism in a Stated Preference Survey

“…In real life, health-related treatment decisions can be confusing and stressful, and there is evidence that patients and people making decisions for others, especially parents, experience difficulty making treatment-related medical decisions. [2][3][4][5][6][7][8] This decisional conflict is defined as the state of uncertainty people experience when deliberating which course of action to take when making treatment-related medical decisions. 9…”