Decision aid prototype development for parents considering adenotonsillectomy for their children with sleep disordered breathing.
BACKGROUND
To describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing.


METHODS
A paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and providers with qualitative content analysis of semi-structured interviews, which included open-ended user feedback.


RESULTS
A steering committee composed of key stakeholders was assembled. A needs assessment was then performed, which confirmed the need for a decision support tool. A decision aid prototype was developed and modified based on semi-structured qualitative interviews and a scoping literature review. The prototype provided information on the condition, risk and benefits of treatments, and values clarification. The prototype underwent three cycles of accessibility, feasibility, and comprehensibility testing, incorporating feedback from all stakeholders to develop the final decision aid prototype.


CONCLUSIONS
A standardized, iterative methodology was used to develop a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. The decision aid prototype appeared feasible, acceptable and comprehensible, and may serve as an effective means of improving shared decision-making.
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Erin
E
Maguire
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. Paul.Hong@iwk.nshealth.ca.|IWK Health Centre, Halifax, NS, Canada. Paul.Hong@iwk.nshealth.ca.|Division of Otolaryngology-Head and Neck Surgery, Halifax, NS, Canada. Paul.Hong@iwk.nshealth.ca.|IWK Health Centre, 5850 University Ave, PO Box 9700, Halifax, NS B3K 6R8, Canada. Paul.Hong@iwk.nshealth.ca.
Paul
P
Hong
IWK Health Centre, Halifax, NS, Canada.|Faculty of Education, Mount Saint Vincent University, Halifax, NS, Canada.
Krista
K
Ritchie
Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
Jeremy
J
Meier
IWK Health Centre, Halifax, NS, Canada.
Karen
K
Archibald
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.|IWK Health Centre, Halifax, NS, Canada.|Department of Anesthesia, Pain Management and Perioperative Medicine, Halifax, NS, Canada.
Jill
J
Chorney
D000233:Adenoidectomy; D000328:Adult; D002648:Child; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017090:Occlusal Splints; D010290:Parents / Q000523:psychology*; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy
Decision aid; Informed consent; Obstructive sleep apnea; Pediatric otolaryngology; Shared decision-making