Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children

Hong, Paul; Maguire, Erin; Purcell, Mary; Ritchie, Krista; Chorney, Jill

doi:10.1001/jamaoto.2016.3365

Cited by 37 publications

(60 citation statements)

References 36 publications

(100 reference statements)

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“…In the current study, 33.3% of parents had clinically significant decisional conflict. This is consistent with other studies assessing elective pediatric surgeries . Because tonsillectomy is one of the most commonly performed procedures in children in North America, the number of parents with significant uncertainty could be substantial.…”

Section: Discussionsupporting

confidence: 88%

“…This is consistent with other studies assessing elective pediatric surgeries. [21][22][23] Because tonsillectomy is one of the most commonly performed procedures in children in North America, the number of parents with significant uncertainty could be substantial. Consistent with previous studies conducted by our group, 22,23 a significantly negative correlation was found between the perceived level of parental SDM and decisional conflict.…”

Section: Discussionmentioning

confidence: 99%

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Decision aid prototype for treatment of pediatric sleep disordered breathing: A randomized pilot study

2018

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Objectives 1) To examine the feasibility and usability of a decision aid prototype (DA) for pediatric obstructive sleep apnea (OSA). 2) to estimate parameters for a future randomized controlled trial. Study Design Multicenter randomized pilot trial. Methods Ninety‐nine parents of children ( < 6 years of age) undergoing consultation for adenotonsillectomy for sleep‐disordered breathing were prospectively enrolled. Families were randomly assigned to receive the DA or to follow standard care procedures. All consultations were video‐recorded and coded with the observing patient involvement in decision making (OPTION) instrument. Following the consultation, parents completed the Decisional Conflict Scale (DCS) and Shared Decision‐Making Questionnaire (SDM‐Q‐9), whereas otolaryngologists completed the physician version (SDM‐Q‐Doc). A subset of parents and surgeons were interviewed to assess the usability of the DA. Results: Overall, a significantly negative correlation between DCS and SDM‐Q‐9 was observed (P < 0.001). Interviews showed that parents found the DA helpful but wanted more time to read and contemplate the information. Both parents and surgeons indicated that instructions on how to use the DA would be beneficial. For parents receiving the DA, the mean total OPTION score was 13.83 out of 40 (standard deviation 5.24), compared to 11.95 (standard deviation 5.21) in those not receiving the DA (P = 0.11). There were no significant differences in the decisional conflict or shared decision making when using the DA. Conclusion: The DA was feasible but used differently among surgeons. The need to improve SDM techniques was suggested by both surgeons and parents. Future studies training otolaryngologists on effective SDM techniques and how to appropriately utilize decision aids may improve SDM for pediatric OSA. Level of Evidence 1b Laryngoscope, 129:229–234, 2019

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Decision aid prototype for treatment of pediatric sleep disordered breathing: A randomized pilot study

2018

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“…This especially may be the case when parents have to make health decisions for their children. Parents can have high decisional conflict concerning surgical decision making for their children . See Table for definition of decisional conflict and other key terms.…”

Section: Discussionmentioning

confidence: 92%

“…Parents can have high decisional conflict concerning surgical decision making for their children. 28 See Table IV for definition of decisional conflict and other key terms. Increasing their knowledge and being informed allows them to decrease this conflict and anxiety to participate in the SDM process.…”

Section: Detection Of Complications*mentioning

confidence: 99%

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

et al. 2017

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“…Other research that evaluates parent-centered outcomes in pediatric tonsillectomy focus on outcomes such as disease-specific and health-related quality of life, parental knowledge about otolaryngologic disease and surgery, parent satisfaction with care, and parental decision conflict for surgery 5,31–33 . Our study complements these previous studies by looking at parental experiences outside of the clinical context.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Parental Perspectives and Concerns About Pediatric Tonsillectomy in Social Media

Hairston

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Harris

et al. 2019

JAMA Otolaryngol Head Neck Surg

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Importance: Tonsillectomy is common in children, but little is known about parental preferences and values concerning this surgery. Social media offers a novel opportunity to evaluate parent understanding and experience of care. Objective: We systematically evaluate posts in a well-known social media site to identify parent perspectives about tonsillectomy in children that may not be apparent in a routine clinical encounter. Design: In this mixed methods analysis, we searched Twitter© for posts (“tweets”) from 2008-2017 written by parents about their child’s tonsillectomy. We applied modified grounded theory to develop a coding taxonomy to classify these tweets. Two reviewers assessed tweets for thematic synthesis and classification. Tweets were quantified, and descriptive statistics were obtained for each theme. Setting: The posts on the social media site www.twitter.com. Participants: A sample of over 700 adult American parents of children who received or will receive a tonsillectomy and posted on Twitter. Main Outcomes and Measures: Themes of parent experiences and perspectives about their child’s tonsillectomy. Results: Of 5801 tweets retrieved, 782 satisfied our inclusion criteria. Tweets fell into overarching themes of 1. procedural concerns (n=549, 70.2%) and 2. attitudes/experiences (n=498, 63.7%). Common tweets related to procedural concerns regarded surgical indication (“sick for months”; n=55,7.0%), recovery [n=227, 29.0%; including child’s attitude (“she is nervous”; n=89, 11.4%) nutrition (“won’t eat”; n=89, 11.4%), and parental experience (“harder on the parents than the kid”;(n=87, 11.1%))]. Common tweets regarding attitudes/experiences included tenor of overall care (“yay for tonsil surgery!”; n=155, 19.8%), and fears/apprehensions (“frankly, I’m terrified”; n=178, 22.8%). Conclusions and Relevance: This analysis provides insight into parent perspectives on pediatric tonsillectomy. Parents commonly tweet concerns about surgery that may not be recognized in routine clinician-parent dialogue. Findings may be used to guide clinicians in educating and counseling parents, and further engaging parents and children in shared decision-making for tonsillectomy.

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Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children

Cited by 37 publications

References 36 publications

Decision aid prototype for treatment of pediatric sleep disordered breathing: A randomized pilot study

Decision aid prototype for treatment of pediatric sleep disordered breathing: A randomized pilot study

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement

Evaluation of Parental Perspectives and Concerns About Pediatric Tonsillectomy in Social Media

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