Shared decision making and autonomy preferences of pediatric health care providers and parents of pediatric patients.

Abstract

The aim of the current study was to determine whether parents of pediatric patients and health care providers (i.e., physicians and nurse practitioners) have different preferences for shared decision making (SDM) and whether these preferences vary across medical situations. Method: Participants consisted of parents of children presenting to pediatric clinics (n = 164) and their matched pediatric health care providers (n = 18). Parents and providers completed measures of preferred autonomy for decision-making in general and across specific medical scenarios. Results: Preferences for autonomy were not uniform and varied across situations among providers and among parents. Further, parents and their providers differed from one another in their autonomy preferences across most scenarios, but not in general preferences. Discussion: The results of this study provide evidence of the complex nature of the provider-parent relationship in pediatric practice. This study highlights the need for providers to consider contextual factors that impact parents' preferences for autonomy when making shared medical decisions.

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“…Additionally, family-related factors and preferences for responsibility in decision making must also be considered, given that preferences for autonomy in decision making are shown to differ across contexts and scenarios (Haynes et al, 2002; Smith et al, 2022). SDM is most appropriate when a family is interested in participating in the decision; however, decision making may be primarily led by an HCP if the family prefers to have less engagement in the decision.…”