Parents' decisional conflict, self-determination and emotional experiences in pediatric otolaryngology: A prospective descriptive-comparative study.
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 personal characteristics and emotional experiences vary as a function of whether or not parents experienced clinically significant levels of decisional conflict.


METHODS
Sixty consecutive parents of children who underwent surgical consultation for elective otolaryngological procedures were prospectively enrolled. Participants completed the Decisional Conflict Scale, Basic Needs Satisfaction Scale, and the Positive and Negative Affect Schedule-Revised.


RESULTS
Eight participants (13.3%) scored over 25 on the Decisional Conflict Scale, a previously defined cut-off indicating clinically significant decisional conflict. Parents who experienced significant decisional conflict felt less autonomous and less related or connected to others as compared to those who did not report significant decisional conflict. In addition, parents who experienced significant decisional conflict reported more negative emotions and fewer positive emotions during the surgical consultation visit. However, parents who reported significant decisional conflict did not report feeling less competent.


CONCLUSIONS
Parental decision-making on whether their child should undergo elective pediatric otolaryngological surgery is a personal and emotional process. Parents' characteristics and experiences should be acknowledged and supported during the surgical consultation. Future research should aim to normalize the decision-making experience for parents, and to allow surgeons to be aware of the importance of decisional needs.
IWK Health Centre, Halifax, Nova Scotia, Canada; Faculty of Education, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
Krista C
KC
Ritchie
IWK Health Centre, Halifax, Nova Scotia, Canada; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Jill
J
Chorney
IWK Health Centre, Halifax, Nova Scotia, Canada; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: Paul.Hong@iwk.nshealth.ca.
Paul
P
Hong
D000328:Adult; D002648:Child; D002675:Child, Preschool; D003220:Conflict, Psychological; D003657:Decision Making; D017558:Elective Surgical Procedures; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012017:Referral and Consultation; D055815:Young Adult
Decision-making; Decisional conflict; Emotional experience; Informed consent; Pediatric otolaryngology; Self-determination