PS1-14 PARENTAL DECISION MAKING INVOLVEMENT AND DECISIONAL CONFLICT: A DESCRIPTIVE STUDY

Sunday, October 18, 2015
Grand Ballroom EH (Hyatt Regency St. Louis at the Arch)
Poster Board # PS1-14

Laura Boland, MSc, PhD(c), University of Ottawa, Institute of Population Health, Ottawa, ON, Canada, Jennifer Kryworuchko, PhD, RN, CNCC(C), University of Saskatchewan College of Nursing, Saskatoon, SK, Canada, Anton Saarimaki, MCS, Ottawa Hospital Research Institute, Ottawa, ON, Canada and Margaret L. Lawson, MD, MSc, FRCP, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
Purpose: To explore parents’ perceived involvement in the decision making process about their child’s health and its association with parents' decisional conflict.

Method: We conducted a cross sectional survey study in a pediatric tertiary care hospital. Our survey was guided by validated decisional conflict screening items (i.e., the SURE test). Parents were eligible to participate if they reported that a decision about their child’s health was discussed during the ambulatory or emergency department visit that they had just completed. All data were analyzed descriptively. The SURE test scores were categorized according to positive and negative screenings of decisional conflict and compared using a chi-squared test. Parents were also categorized according to whether or not they reported being offered treatment options and analyzed across SURE test items using chi-squared tests and risk ratios with 95% confidence intervals.

Result: 429 respondents were included in the analysis. Forty-eight percent of parents reported not being offered treatment options and 24% screened positive for decisional conflict. Parents who reported being offered options experienced less decisional conflict than parents who reported not being offered options (p < 0.001). Further, parents who reported being provided options were more likely to: feel certain about the decision (RR 1.08, 95% CI 1.02-1.15); understand the information (RR 1.92, 95% CI 1.63-2.28); be clear about the risks and benefits (RR 1.22, 95% CI 1.05-1.20); and, have sufficient encouragement to make a choice (RR 1.07, 95% CI 1.03-1.11).

Conclusion: Many parents in our sample experienced decisional conflict after their clinical visit. Involving parents in the decision making process may reduce their decisional conflict. Evidence based interventions that support parent decision making involvement, such as shared decision making, should be implemented and evaluated in pediatrics as a strategy to reduce parents’ decisional conflict.

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