Provider perspectives on shared decision-making regarding hypospadias surgery.

Area of Science:

• Pediatric Urology
• Shared Decision-Making (SDM)
• Health Services Research

Background:

• Parents often experience decisional conflict and regret concerning hypospadias surgery.
• Shared decision-making (SDM) may alleviate these issues, but its implementation is complex.
• Provider investment is crucial for effectively integrating SDM into clinical practice.

Purpose of the Study:

• To explore pediatric providers' perspectives on SDM for hypospadias.
• To identify clinical applications and barriers to adopting SDM in hypospadias care.
• To facilitate a discussion on SDM anchored on hypospadias among healthcare professionals.

Main Methods:

• Conducted two focus groups with pediatric urology and general pediatric providers.
• Utilized guided discussions about SDM in the context of hypospadias.
• Analyzed audio recordings and transcriptions using directed qualitative content analysis to identify themes.

Main Results:

• Providers recognized key SDM components: engaging families, informing about options, and clarifying values.
• SDM was deemed useful for preference-sensitive conditions like hypospadias and improving parental compliance.
• Identified barriers included paternalism, misperceptions of evidence, pre-formed parental decisions, provider bias, and time constraints.

Conclusions:

• Pediatric providers are knowledgeable about SDM and its applications for hypospadias.
• Modifiable barriers to SDM adoption in pediatric hypospadias care were identified.
• Future plans include implementing a hypospadias decision aid and provider training to address knowledge gaps.