title: Cross-sectional evaluation of parental decision making factors for vesicoureteral reflux management in children.
abstract: OBJECTIVE
  Parental decision making in children with vesicoureteral reflux has potentially become more complex with the evolution of ethnic diversity in the United States, the Internet, the publication of contradictory clinical data and the emergence of minimally invasive surgery. We performed a cross-sectional study of parental management for pediatric vesicoureteral reflux.
  
  
  METHODS
  We administered a 26-item questionnaire to parents of children with vesicoureteral reflux seen at Texas Children's Hospital urology offices or undergoing antireflux surgery at that institution. Univariate and multivariate analysis was done on patient disease characteristics, demographics, predicted reflux duration, surgery success rate, antibiotic cessation, complication risk, financial considerations, urologist recommendations, Internet information, friend recommendations, and postoperative voiding cystourethrography, renal ultrasound and recovery.
  
  
  RESULTS
  Enrolled in the study were 15 boys and 49 girls with a mean age of 3.5 years and a mean reflux grade of 2.8. Of the cases 37 were bilateral. Parents chose endoscopic treatment in 38 children, open ureteroneocystostomy in 9, antibiotic prophylaxis in 14 and observation without antibiotics in 3. Univariate analysis suggested that Hispanic parents rated ultrasound and financial considerations as more important than white parents (p <0.05). Multivariate analysis revealed that differences seen on univariate analysis may have been due to an association between race and income. Finally, 93.6% of parents rated urologist opinion as very or extremely important.
  
  
  CONCLUSIONS
  Data indicate that the parents of our patients highly value the opinion of the pediatric urologist when choosing treatment for their children with vesicoureteral reflux. Despite social changes the physician-parental relationship remains critical. Differences in parental decision making may be linked to associations between race and income.
authors: Department of Urology, Stanford University School of Medicine, Stanford, California 94305, USA. mhhsieh@stanford.edu
authors: Michael H
authors: MH
authors: Hsieh
authors: Ramiro J
authors: RJ
authors: Madden-Fuentes
authors: Aaron
authors: A
authors: Bayne
authors: Erika
authors: E
authors: Munch
authors: Patience
authors: P
authors: Wildenfels
authors: Sandra J
authors: SJ
authors: Alexander
authors: Edmond T
authors: ET
authors: Gonzales
authors: Lars J
authors: LJ
authors: Cisek
authors: Eric A
authors: EA
authors: Jones
authors: David R
authors: DR
authors: Roth
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D008297:Male; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires; D014718:Vesico-Ureteral Reflux / Q000628:therapy*; D044465:White People