Experiences of decisional conflict in parents offered hip reconstructive surgery for their child with cerebral palsy

Area of Science:

• Pediatric Orthopedics
• Healthcare Decision-Making
• Quality of Life Research

Background:

• Cerebral palsy (CP) significantly impacts a child's mobility and quality of life.
• Hip displacement is a common complication in non-ambulant children with CP, often requiring surgical intervention.
• Parental involvement is crucial in medical decision-making for children with complex health conditions.

Purpose of the Study:

• To explore the extent of decisional conflict experienced by parents offered hip surgery for their child with non-ambulant CP.
• To understand parents' decision-making experiences and identify factors influencing their choices regarding this surgical procedure.

Main Methods:

• A mixed-methods approach combining surveys and semi-structured interviews.
• Utilized the Decisional Conflict Scale (DCS) to quantify decisional conflict.
• Employed the Ottawa Decision Support Framework and Interpretive Description methodology for data analysis.

Main Results:

• 36.4% of surveyed parents reported significant decisional conflict (DCS score ≥ 25).
• Key themes emerged from interviews: focus on future quality of life, processing time, perceived necessity of surgery, and the importance of information.
• Parents highlighted the need for sufficient deliberation time and clear, accessible information with opportunities for questions.

Conclusions:

• A substantial minority of parents face decisional conflict when considering hip surgery for their child with CP.
• Healthcare providers can mitigate parental uncertainty by focusing on the child's quality of life and care goals.
• Ensuring adequate information and decision-making time are vital strategies to support parents in this critical process.