title: Shared decision-making in pediatric intensive care units: a qualitative study with physicians, nurses and parents.
abstract: OBJECTIVE
  To understand how decisions are made in Intensive Care Unit (ICU) settings where critically-ill children require life-support decisions and what are the perceptions of health professionals and parents.
  
  
  METHODS
  In this qualitative study, in-depth, semi-structured, face to face interviews with 8 doctors, 9 nurses and 6 parents of critically ill children were conducted. Interviews were digitally recorded and transcribed. The transcriptions were further analyzed following open coding and formation of themes.
  
  
  RESULTS
  The themes were discussed in two major titles: perceived roles and emotions during the decision-making process. All nurses and patients agreed that the decision maker should be the physician. Nurses understood patients' emotions better and had a closer relation with the parents. Both doctors and nurses thought that parents could not have all responsibilities about treatment choices, because they do not have the required knowledge. Similarly parents were afraid to make a wrong decision, thus they wanted to leave this to the doctors.
  
  
  CONCLUSIONS
  The present study revealed that shared-decision making is not well understood by health care professionals in Turkey. Doctor is the major decision-making authority and this is also accepted and preferred by the patients and nurses.
authors.affiliation: Department of Family Medicine, Ankara Numune Training and Research Hospital, Talatpasa Bulvari No: 5, Altindag, 06100, Ankara, Turkey.
authors.forename: Rabia
authors.initials: R
authors.lastname: Kahveci
authors.forename: Duygu
authors.initials: D
authors.lastname: Ayhan
authors.forename: Pınar
authors.initials: P
authors.lastname: Döner
authors.forename: Fatma Gökşin
authors.initials: FG
authors.lastname: Cihan
authors.forename: Esra Meltem
authors.initials: EM
authors.lastname: Koç
mesh_terms: D002675:Child, Preschool; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy; D003657:Decision Making; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009726:Nurses / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D014421:Turkey
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