title: Outpatient parents' views on shared-decision-making at an Italian children's hospital.
abstract: Information is lacking on what parents in southern European countries know and how they view clinical shared-decision-making (SDM) for their children. This survey assesses general parental views on SDM and patient-physician SDM relationships in an Italian paediatric outpatients' clinic. In a 3-month cross-sectional survey, we enrolled 458 consecutive native and foreign Italian-speaking parents bringing their children to our public hospital for various reasons. Parents completed an anonymous questionnaire exploring their general views on SDM, including what doctor-patient relationship predominates today, and what approach reassures them most. Multivariate logistic regression analysed outcome data from parental questionnaire answers. Results are reported as percentages, odds ratios (OR) and 95% confidence intervals (CI). Multivariate logistic regression showed that 440 parents (96.1%) appreciated SDM, 245 (53.5%) preferred SDM for choosing children's treatment, 126 (27.5%) answered that SDM is the predominant relationship today, and most parents 275 (60.0%) felt reassured by SDM. More native than foreign Italian-speaking parents preferred SDM (97.0 vs 89.7%, OR = 3.8; 95% CI = 1.4-10.8). Highly-educated parents preferred SDM for choosing their child's therapy (57.9 vs 34.1%, OR = 2.7; 95% CI = 1.6-4.4) and this approach reassured them (64.3 vs 41.2%, OR = 2.5; 95% CI = 1.6-4.1). In conclusion, parents bringing children to an Italian outpatient clinic, especially highly-educated parents, wish to be offered SDM and find it reassuring. These findings should encourage paediatricians working in a challenging multicultural environment to change their physician-centred approach and engage parents in tailored SDM strategies.
authors.affiliation: Unit of Clinical Epidemiology Bambino Gesù, Children's Hospital, IRCCS, Viale Ferdinando Baldelli 41, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rosati
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Di Salvo
authors.affiliation: Department of Diagnostic Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Amico
authors.affiliation: Department of Diagnostic Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Balduzzi
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Giampaolo
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rita Marina Mazziotta
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Guerra
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Menichella
authors.affiliation: Department of Paediatrics, Outpatients' Unit, Bambino Gesù, Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, Italy.
authors.forename: Stefania P
authors.initials: SP
authors.lastname: Cosentino
authors.affiliation: Faculty of Medicine and Surgery, Sapienza University, Piazzale Aldo Moro 5, Rome, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Carlino
authors.affiliation: Unit of Clinical Epidemiology Bambino Gesù, Children's Hospital, IRCCS, Viale Ferdinando Baldelli 41, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Ciommo
mesh_terms: D003430:Cross-Sectional Studies; D003469:Culture; D003657:Decision Making; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007558:Italy; D008297:Male; D010045:Outpatients; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires