Parental Decision-Making in the Pediatric Intensive Care Unit: An Integrative Review

Area of Science:

• Pediatric Intensive Care
• Medical Decision-Making
• Parental Health Psychology

Background:

• Parents frequently make critical healthcare decisions for children in the pediatric intensive care unit (PICU).
• Factors influencing these parental decisions in pediatric critical illness are complex and varied.
• Understanding parental decision-making is crucial for effective pediatric critical care.

Purpose of the Study:

• To review and synthesize empirical literature on factors influencing parents' decision-making regarding their seriously ill children's care in the PICU.
• To identify key themes and findings from studies published between 2013 and 2018.
• To provide insights into parental perspectives on critical care decisions.

Main Methods:

• An integrative review methodology was employed.
• Literature search focused on empirical studies published from 2013 to 2018.
• Seventeen studies met the inclusion criteria for analysis.

Main Results:

• Effective parent-clinician communication is a critical factor in PICU decision-making.
• Most parents desire to be the ultimate decision-makers for their critically ill child.
• Parental emotions, support systems, and the child's clinical status significantly impact decision-making processes.

Conclusions:

• Parental perspectives are vital when discussing serious illness care for children in the PICU.
• Further research is needed on the impact of the parent-clinician interaction on decision-making and outcomes.
• Acknowledging parental influence can improve care planning and patient outcomes in pediatric critical care.