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Pediatric plastic surgery patients and caregivers often disagree on decision-making roles. While most caregivers prefer shared decisions, children, especially older ones, desire more autonomy, impacting satisfaction.

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Area of Science:

  • Pediatric Plastic Surgery
  • Patient-Centered Care
  • Shared Decision-Making

Background:

  • Shared decision-making (SDM) is crucial for patient-centered care but its application in pediatric plastic surgery is not well-defined.
  • Understanding preferences for involvement in surgical decisions is key for optimizing care.

Purpose of the Study:

  • To determine the preferred level of involvement in surgical decision-making among pediatric patients, their caregivers, and surgeons.
  • To identify discrepancies in decision-making preferences between children, caregivers, and surgeons.

Main Methods:

  • Surveyed 100 pediatric plastic surgery patients and their caregivers on decision-making preferences.
  • Assessed agreement using Fleiss' kappa and analyzed demographic associations with multinomial logistic regression and Chi-square tests.

Main Results:

  • Low agreement (34%) between children and caregivers on decision-making preferences (k=0.04).
  • Majority favored shared decision-making (children 40%, caregivers 67%).
  • Children's preferences correlated with age; older children preferred more autonomy. Caregiver preferences varied with child's gender, favoring more autonomy for males.

Conclusions:

  • Significant divergence exists between children's and caregivers' preferences for surgical decision-making in pediatric plastic surgery.
  • Children, particularly adolescents, increasingly desire autonomy, contrasting with caregiver preferences for shared decision-making.
  • Surgeons must address these differing preferences to enhance patient and caregiver satisfaction and optimize treatment plan discussions.