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Decisional Conflict in Parents Considering Bone-Anchored Hearing Devices in Children With Unilateral Aural Atresia
M Elise Graham1, Rebecca Haworth2, Jill Chorney1
1IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Many parents experience significant decisional conflict when deciding on bone-anchored hearing devices (BAHD) for children with unilateral aural atresia. This conflict highlights the need for further research into the impact of these decisions on patient outcomes.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Decision Science
Background:
- Unilateral aural atresia presents unique challenges in pediatric hearing loss.
- The efficacy and benefits of bone-anchored hearing devices (BAHD) for this condition remain a subject of debate.
- Parental understanding and decision-making are crucial for elective surgical interventions.
Purpose of the Study:
- To assess the level of decisional conflict experienced by caregivers of children with unilateral aural atresia considering BAHD.
- To identify factors contributing to parental uncertainty regarding BAHD implantation.
Main Methods:
- Caregivers of pediatric patients with unilateral aural atresia underwent a standardized consultation for percutaneous BAHD.
- Participants completed the Decisional Conflict Scale (DCS) questionnaire post-consultation.
- Demographic data and DCS scores were analyzed to quantify decisional conflict.
Main Results:
- Over 43% of caregivers (10 out of 23) reported significant decisional conflict (DCS score ≥ 25).
- Caregivers who did not opt for surgery showed higher median DCS scores (23.44) compared to those who chose surgery (5.47).
- Mothers reported higher median DCS scores (25) than fathers (3.91).
Conclusions:
- A substantial proportion of parents experience significant decisional conflict regarding BAHD for unilateral aural atresia.
- The findings underscore the complexity of parental decision-making for this elective procedure.
- Further investigation is warranted to explore the relationship between decisional conflict and health outcomes in pediatric BAHD recipients.
Objective:
The benefits of bone-anchored hearing devices (BAHD) in children with unilateral aural atresia are controversial. We sought to determine whether there is parental decisional conflict surrounding elective placement of BAHD for this indication.
Methods:
Caregivers of pediatric patients with unilateral aural atresia and normal contralateral ear undergoing percutaneous BAHD consultation were enrolled. All consultations were carried out by one pediatric otolaryngologist in a consistent manner. After consultation, the participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire.
Results:
Twenty-three caregivers of 15 male (65.2%) and 8 female (34.8%) children (mean age 5.65 years) participated. The overall median DCS score was 15.63 (standard error = 4.21). Significant decisional conflict (DCS score ≥ 25) was found in 10 participants (43.5%). The median DCS score in the group choosing surgery was 5.47, and it was 23.44 in those who did not choose surgery (Mann-Whitney U = 39, Z = -1.391, P = .164). The median DCS score for mothers and fathers was 25 and 3.91, respectively.
Conclusion:
Many parents experienced significant decisional conflict when considering percutaneous BAHD surgery in children with unilateral aural atresia in our study population. Future research should explore the impact of decisional conflict on health outcomes.
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