title: Comparison of underlying factors behind parental refusal or consent for lumbar puncture.
abstract: BACKGROUND
  Although lumbar puncture (LP) is a safe procedure in experienced hands, some parents fear having it performed on their children and refuse consent. The factors associated with this refusal are unclear, and any differences with consenting parents might provide clues as to how to address them. Therefore, we compared the underlying factors between the parents who refuse and those who consent to this procedure, as well as their children's outcomes.
  
  
  METHODS
  A prospective study of the two groups of parents was conducted by a face-to-face structured interview. Parents' demographic factors, knowledge, perceptions, beliefs and attitudes, as well as their children's outcomes, were compared. The odds ratio (OR) with 95% confidence intervals was calculated for significant associations.
  
  
  RESULTS
  Consent was declined by 24 out of 55 families (44%). Alternative options were offered more often to those refusing consent (OR=5.7). Significantly more parents who refused consent also refused bladder catheterization (OR=18), knowing someone with complications following LP (OR=8.7), felt that it was not needed (OR=7.9) or that it induced complications (OR=12.5). A significantly higher proportion of the consenting parents were aware that meningitis might cause convulsions (OR=4.6), deafness or blindness (OR=2.9).
  
  
  CONCLUSIONS
  The differences in the understanding, perceptions, beliefs and fears between the parents who refused consent and those who agreed, can provide clues to the developing of appropriate strategies when requesting consent for LP.
authors.affiliation: Faculty of Medicine & Health Sciences, Al Ain, United Arab Emirates, hassib.narchi@uaeu.ac.ae.
authors.forename: Hassib
authors.initials: H
authors.lastname: Narchi
authors.forename: Ghassan
authors.initials: G
authors.lastname: Ghatasheh
authors.forename: Noura Al
authors.initials: NA
authors.lastname: Hassani
authors.forename: Layla Al
authors.initials: LA
authors.lastname: Reyami
authors.forename: Qudsiya
authors.initials: Q
authors.lastname: Khan
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D033282:Parental Consent; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D013129:Spinal Puncture; D016312:Treatment Refusal / Q000523:psychology*; D014546:Urinary Catheterization