title: Understanding shared decision making in pediatric otolaryngology.
abstract: OBJECTIVE
  The aim of this study was to describe the level of decisional conflict experienced by parents considering surgery for their children and to determine if decisional conflict and perceptions of shared decision making are related.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Academic pediatric otolaryngology clinic.
  
  
  METHODS
  Sixty-five consecutive parents of children who underwent surgical consultation for elective otolaryngological procedures were prospectively enrolled. Participants completed the Shared Decision Making Questionnaire and the Decisional Conflict Scale. Surgeons completed the Shared Decision Making Questionnaire-Physician version.
  
  
  RESULTS
  Eleven participants (16.9%) scored over 25 on the Decisional Conflict Scale, a previously defined clinical cutoff indicating significant decisional conflict. Parent years of education and parent ratings of shared decision making were significantly correlated with decisional conflict (positively and negatively correlated, respectively). A logistic regression indicated that shared decision making but not education predicted the presence of significant decisional conflict. Parent and physician ratings of shared decision making were not related, and there was no correlation between physician ratings of shared decision making and parental decisional conflict.
  
  
  CONCLUSIONS
  Many parents experienced considerable decisional conflict when making decisions about their child's surgical treatment. Parents who perceived themselves as being more involved in the decision-making process reported less decisional conflict. Parents and physicians had different perceptions of shared decision making. Future research should develop and assess interventions to increase parents' involvement in decision making and explore the impact of significant decisional conflict on health outcomes.
authors: IWK Health Centre, Halifax, Nova Scotia, Canada Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Jill
authors: J
authors: Chorney
authors: IWK Health Centre, Halifax, Nova Scotia, Canada Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Rebecca
authors: R
authors: Haworth
authors: IWK Health Centre, Halifax, Nova Scotia, Canada Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: M Elise
authors: ME
authors: Graham
authors: IWK Health Centre, Halifax, Nova Scotia, Canada.
authors: Krista
authors: K
authors: Ritchie
authors: IWK Health Centre, Halifax, Nova Scotia, Canada School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Janet A
authors: JA
authors: Curran
authors: IWK Health Centre, Halifax, Nova Scotia, Canada Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada Paul.Hong@iwk.nshealth.ca.
authors: Paul
authors: P
authors: Hong
mesh_terms: D002648:Child; D003657:Decision Making; D017558:Elective Surgical Procedures; D054541:Family Conflict; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures; D010290:Parents; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: decisional conflict; informed consent; pediatric otolaryngology; shared decision making