title: Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children.
abstract: Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and preferences. Shared decision making is thought to have a positive influence on the decision-making process in medicine.
  
  
  
  To describe the level of decisional conflict and decisional regret experienced by parents considering surgery for their children and to determine relations among decisional conflict, decisional regret, and shared decision making.
  
  
  
  A prospective cohort study was conducted at an academic pediatric otolaryngology clinic. Participants included 126 parents of children younger than 6 years who underwent consultation for adenotonsillectomy or tympanostomy tube insertion.
  
  
  
  Parent participants completed the Shared Decision Making Questionnaire-Parent version, Decisional Conflict Scale (DCS), and Decisional Regret Scale (DRS). Surgeons completed the Shared Decision Making Questionnaire-Physician version.
  
  
  
  This study included 126 parents; 102 women (mean [SD] age, 33.2 [5.1] years) and 24 men (mean [SD] age, 35.6 [6.3] years). Overall, 34 parents (26%) reported clinically significant decisional conflict. Only 1 parent experienced moderate to strong decisional regret; 28 parents (43.7%) had mild decisional regret. Both parent and physician ratings of shared decision making were significantly negatively correlated with total DCS scores. Parent SDM-Q-9 and total DCS scores were significantly negatively correlated (rs[118] = -0.582; P < .001). Similarly, physician SDM-Q-Doc and total DCS scores were also significantly negatively correlated (rs[118] = -0.221; P = .04). Only parent ratings of shared decision making were significantly negatively correlated with total DRS scores (rs[63] = -0.254; P = .045). Those parents with clinically significant decisional conflict had significantly higher DRS scores (P = .02).
  
  
  
  Many parents experienced significant decisional conflict when making decisions about their child's elective surgical treatment. Parents who perceived themselves as being more involved in the decision-making process reported less decisional conflict and decisional regret. Future research should explore the influence of decision quality on health outcomes and develop methods to improve shared decision making.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada2IWK Health Centre, Halifax, Nova Scotia, Canada.
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: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Purcell
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada3Faculty of Education, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
authors.forename: Krista C
authors.initials: KC
authors.lastname: Ritchie
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada4Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Chorney
mesh_terms: D000233:Adenoidectomy; D000328:Adult; D002675:Child, Preschool; D003220:Conflict, Psychological; D003657:Decision Making; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012017:Referral and Consultation; D014068:Tonsillectomy; D055815:Young Adult