title: Parental angst making and revisiting decisions about treatment of attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral conditions of childhood and adolescence. Despite availability of effective treatment options, initiation of treatment is variable and persistence with therapeutic regimens is poor.
  
  
  OBJECTIVE
  We sought to better understand how parents make decisions about treatment for their child or adolescent with ADHD.
  
  
  METHODS
  We conducted a qualitative study among parents of children and adolescents; 52 parents participated in 1 of 12 focus groups. Parents answered questions about decision-making, information sharing, and sources of conflict and uncertainty. Sessions were audiotaped and transcribed verbatim. Themes were coded independently by 4 of the investigators, who then agreed on common themes.
  
  
  RESULTS
  Parents in our study made decisions about treatment for their child with ADHD in the midst of experiencing a variety of emotions as they witnessed child functional impairments at home and at school. In addition, parents felt stress as a result of their daily efforts to manage their child's struggles. Multiple factors influenced the decision to initiate medication. Subsequently, revisiting the decision to give their child medicine for ADHD was common. Many parents contrasted time on and off medicine to help inform management decisions. Trials stopping medication were almost always parent- or child-initiated.
  
  
  CONCLUSIONS
  Decisions about medication use for children and adolescents with ADHD are made and frequently revisited by their parents. Choices are often made under stressful conditions and influenced by a variety of factors. Striking a balance between benefits and concerns is an ongoing process that is often informed by contrasting time on and off medication. Development of strategies to support families across the continuum of decisions faced while managing ADHD is warranted.
authors: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. bill.brinkman@cchmc.org
authors: William B
authors: WB
authors: Brinkman
authors: Susan N
authors: SN
authors: Sherman
authors: April R
authors: AR
authors: Zmitrovich
authors: Marty O
authors: MO
authors: Visscher
authors: Lori E
authors: LE
authors: Crosby
authors: Kieran J
authors: KJ
authors: Phelan
authors: Edward F
authors: EF
authors: Donovan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009820:Ohio; D010290:Parents / Q000523:psychology*; D012017:Referral and Consultation; D016896:Treatment Outcome; D035501:Uncertainty; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants