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Published on: December 6, 2016
Decision aid for pediatric sleep disordered breathing: A randomized trial
Purcell Chad1, Corsten Gerard2, Hong Paul2
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
A decision aid (DA) for pediatric sleep-disordered breathing (SDB) significantly reduced parental decisional conflict and improved shared decision-making perceptions. This tool empowers parents in healthcare choices for their children.
Area of Science:
- Pediatric Otolaryngology
- Health Decision Science
Background:
- Sleep-disordered breathing (SDB) in children presents complex treatment decisions for parents.
- Shared decision-making (SDM) is crucial for effective pediatric care.
- Parental decisional conflict can impact treatment adherence and satisfaction.
Purpose of the Study:
- To evaluate the impact of a decision aid (DA) on parental perceptions of SDM.
- To assess if a DA can reduce decisional conflict in parents of children with SDB.
- To explore the relationship between decisional conflict and SDM in this population.
Main Methods:
- A prospective randomized controlled trial was conducted.
- 101 parents of children with mild to moderate SDB were randomized to use a DA or not.
- Outcomes included the Decisional Conflict Scale (DCS) and Shared Decision-Making Questionnaire (SDM-Q-9).
Main Results:
- Parents using the DA reported significantly lower DCS scores (p=0.005) and higher SDM-Q-9 scores (p=0.035).
- Decisional conflict was negatively correlated with shared decision-making (Spearman's r = -0.680, p < 0.001).
- No significant difference in OPTION scores was observed between groups.
Conclusions:
- The decision aid effectively reduced decisional conflict for parents making SDB treatment decisions.
- The DA enhanced parents' perception of involvement in the decision-making process.
- Findings support the use of DAs to improve SDM in pediatric otolaryngology.
Objective:
The objective of this study was to assess whether a decision aid (DA) can increase parental perceptions of shared decision making and reduce decisional conflict.
Study Design:
Prospective randomized controlled trial.
Setting:
January 2017-June 2018 Single-Center Tertiary Pediatric Otolaryngology Practice in Halifax Nova Scotia, Canada.
Methods:
English-speaking parents of children younger than 6 years with mild to moderate SDB were included. Parents were randomized to the intervention, with in-person consultation using the DA or the control group, without the DA. Outcomes measured were the decisional conflict scale (DCS), shared decision-making questionnaire (SDM-Q-9) and the OPTION instrument. Descriptive, parametric and non-parametric analyses were performed where appropriate. Spearman's r correlations were used to examine the relation between outcome measures.
Results:
101 parents were included (n = 50 DA/51 control). Parents who used the DA reported lower median DCS scores (6.50 vs. 19.25; p = 0.005) and higher SDM-Q-9 scores (93.59 vs. 80.74; p = 0.035). The DCS scores were significantly negatively correlated to SDM-Q-9 scores (Spearman's r = -0.680; p < 0.001). No significant differences were found in mean OPTION scores between groups. SDM-Q-9 and OPTION scores were positively correlated (Spearman's r = 0.590; p < 0.010).
Conclusion:
Parents using our DA reported lower levels of decisional conflict and greater perceived involvement in the decision-making process for their children with SDB.
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