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Shared decision making during surgical consultations: An observational study in pediatric otolaryngology

J Melong1, J Meier2, P Hong3

  • 1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|October 17, 2018
PubMed

Insights

Pediatric otolaryngologists focused on information sharing rather than collaborative decision-making. Parent and physician perceptions of shared decision-making (SDM) did not align with observed behaviors.

Area of Science:

  • Pediatric Otolaryngology
  • Health Communication
  • Shared Decision-Making (SDM)

Background:

  • Shared decision-making (SDM) is crucial for collaborative healthcare choices between patients, families, and clinicians.
  • Understanding how pediatric otolaryngologists engage parents in SDM is essential for improving patient-centered care.

Purpose of the Study:

  • To explore the extent to which pediatric otolaryngologists involve parents in SDM during consultations.
  • To identify factors influencing parental involvement in SDM for pediatric surgical procedures.

Main Methods:

  • 96 children undergoing elective pediatric otolaryngology surgery were enrolled.
  • Surgical consultations were video-recorded and analyzed using the OPTION instrument for SDM levels.
  • Parents and physicians completed validated questionnaires (SDM-Q-9, SDM-Q-Doc) for subjective assessment.

Main Results:

  • Observed SDM levels were generally low, with consultations focusing more on information sharing than collaboration.
  • Female children and those with prior surgery history were more likely to be involved in SDM.
  • Consultation length positively correlated with parental SDM scores, but subjective perceptions did not align with observed behaviors.

Conclusions:

  • Pediatric otolaryngology consultations prioritize treatment decisions and information dissemination over true collaborative decision-making.
  • Discrepancies exist between parent/physician perceptions and observed SDM behaviors.
  • Further research is needed to enhance surgeons' facilitation of SDM in pediatric care.
Abstract

Keywords:
Informed consentPediatric otolaryngologyShared decision makingTonsillectomyTympanostomy tube insertion

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