title: Shared decision-making in pediatric otolaryngology: Parent, physician and observational perspectives.
abstract: OBJECTIVE
  To describe physician and parent behavior during pediatric otolaryngology surgical consultations, and to assess whether perceptions of shared decision-making and observed behavior are related.
  
  
  METHODS
  Parents of 126 children less than 6-years of age who underwent consultation for adeontonsillectomy or tympanostomy tube insertion were prospectively enrolled. Parents completed the Shared Decision-Making Questionnaire-Patient version (SDM-Q-9), while surgeons completed the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) after the consultation. Visits were video-recorded and analyzed using the Roter Interaction Analysis System to quantify physician and parent involvement during the consultation.
  
  
  RESULTS
  Perceptions of shared decision-making between parents (SDM-Q-9) and physicians (SDM-Q-Doc) were significantly positively correlated (p = 0.03). However, there was no correlation between parents' perceptions of shared decision-making and observations of physician and parent behavior/involvement (proportion of physician socioemotional talk, task-focused talk, or proportion of parent talk). Surgeons' perceptions of shared decision-making were correlated with physician task-focused talk and proportion of parent talk.
  
  
  CONCLUSIONS
  Parents and physicians had similar perceptions of the degree of shared decision-making to be taking place during pediatric otolaryngology consultations. However, there was variability in the degree to which parents participated, and parent perceptions of shared decision-making were not correlated with actual observed involvement.
authors.affiliation: 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.
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Maguire
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada.
authors.forename: Ayala Y
authors.initials: AY
authors.lastname: Gorodzinsky
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Curran
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Faculty of Education, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
authors.forename: Krista
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada; Department of Anesthesia, Pain Management and Perioperative Medicine, Halifax, Nova Scotia, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Chorney
mesh_terms: D000233:Adenoidectomy; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation; D010036:Otolaryngology; D010290:Parents / Q000523:psychology*; D010358:Patient Participation; D010372:Pediatrics; D010465:Perception; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D066231:Surgeons / Q000523:psychology*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D055815:Young Adult
keywords: Decision aids; Decisional conflict; Informed consent; Pediatric otolaryngology; Shared decision-making