Factors influencing shared decision-making and decision regret in parents of children undergoing myopia control...

Childhood myopia is highly prevalent in East Asia, where treatment decisions are typically made by parents. Although effective interventions are available, little is known about how parental knowledge and involvement influence decision quality. This study examined the relationships among parental knowledge, shared decision-making (SDM), and decision regret in parents of children with myopia, and assessed how treatment type and follow-up behaviors affect decision-making experiences.

A cross-sectional survey was conducted with 314 parents of children newly diagnosed with myopia. Data were collected using an online questionnaire that captured demographic and clinical characteristics, treatments received by the children, parents' knowledge of myopia control, SDM, and decision regret. Multiple regression analysis was performed to identify the predictors of decision regret.

Shorter follow-up intervals (≤ 6 months), higher parental knowledge, and the use of orthokeratology were significantly associated with lower decision regret, whereas atropine therapy was associated with higher regret. However, when SDM was included in the final model, treatment type was no longer a significant predictor, and SDM emerged as the strongest negative predictor of regret (unstandardized regression coefficient [B] = -0.410, 95% confidence interval [CI] [-0.507, - 0.314], p < .001). This attenuation suggests that the observed relationship between treatment type and decision regret may be partly explained by differences in SDM, potentially reflecting more extensive consultation and engagement in certain modalities such as orthokeratology. The final model explained 27.4% of the variance in decision regret.

SDM plays a critical role in reducing parents' decision regret, regardless of the treatment modality. Enhancing communication about treatment options, particularly atropine therapy and axial length monitoring, may support more informed and satisfactory decision-making. The development of longitudinal studies and SDM tools tailored for parents with lower literacy is recommended to strengthen treatment adherence and improve clinical outcomes.