title: Relationship of external influence to parental distress in decision making regarding children with a life-threatening illness.
abstract: OBJECTIVE
  To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship.
  
  
  METHODS
  Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping.
  
  
  RESULTS
  More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high.
  
  
  CONCLUSIONS
  External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. millerv@email.chop.edu
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Miller
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Luce
authors.forename: Robert M
authors.initials: RM
authors.lastname: Nelson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004644:Emotions; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D009369:Neoplasms / Q000523:psychology; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires