title: Parental explicit heuristics in decision-making for children with life-threatening illnesses.
abstract: OBJECTIVE
  To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions.
  
  
  METHODS
  Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children's Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed.
  
  
  RESULTS
  All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice.
  
  
  CONCLUSIONS
  Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process.
authors: CHOP North-Room 1523, Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 10194, USA.
authors: Chris B
authors: CB
authors: Renjilian
authors: James W
authors: JW
authors: Womer
authors: Karen W
authors: KW
authors: Carroll
authors: Tammy I
authors: TI
authors: Kang
authors: Chris
authors: C
authors: Feudtner
mesh_terms: D000293:Adolescent; D001045:Aphorisms and Proverbs as Topic; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D003142:Communication; D016638:Critical Illness / Q000523:psychology* / Q000628:therapy; D003657:Decision Making; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007406:Interview, Psychological; D007600:Judgment; D008297:Male; D010166:Palliative Care / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D015143:Philadelphia; D011340:Problem Solving; D011368:Professional-Family Relations; D011446:Prospective Studies; D055815:Young Adult