title: Decisional Conflict in Parents Considering Bone-Anchored Hearing Devices in Children With Unilateral Aural Atresia.
abstract: OBJECTIVE
  The benefits of bone-anchored hearing devices (BAHD) in children with unilateral aural atresia are controversial. We sought to determine whether there is parental decisional conflict surrounding elective placement of BAHD for this indication.
  
  
  METHODS
  Caregivers of pediatric patients with unilateral aural atresia and normal contralateral ear undergoing percutaneous BAHD consultation were enrolled. All consultations were carried out by one pediatric otolaryngologist in a consistent manner. After consultation, the participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire.
  
  
  RESULTS
  Twenty-three caregivers of 15 male (65.2%) and 8 female (34.8%) children (mean age 5.65 years) participated. The overall median DCS score was 15.63 (standard error = 4.21). Significant decisional conflict (DCS score ≥ 25) was found in 10 participants (43.5%). The median DCS score in the group choosing surgery was 5.47, and it was 23.44 in those who did not choose surgery (Mann-Whitney U = 39, Z = -1.391, P = .164). The median DCS score for mothers and fathers was 25 and 3.91, respectively.
  
  
  CONCLUSIONS
  Many parents experienced significant decisional conflict when considering percutaneous BAHD surgery in children with unilateral aural atresia in our study population. Future research should explore the impact of decisional conflict on health outcomes.
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: M Elise
authors.initials: ME
authors.lastname: Graham
authors.affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Haworth
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Chorney
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Manohar
authors.initials: M
authors.lastname: Bance
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada Paul.Hong@iwk.nshealth.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
mesh_terms: D002648:Child; D002675:Child, Preschool; D003220:Conflict, Psychological; D003657:Decision Making; D004431:Ear, External / Q000002:abnormalities*; D005260:Female; D006310:Hearing Aids / Q000523:psychology*; D006314:Hearing Loss, Conductive / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D019919:Prosthesis Implantation; D011795:Surveys and Questionnaires
keywords: bone-anchored hearing device; decisional conflict; informed consent; unilateral aural atresia