Journal article
A valued voice: A qualitative analysis of parental decision-making preferences in emergent paediatric surgery
Health expectations : an international journal of public participation in health care and health policy, Vol.26(1), pp.531-541
02/2023
DOI: 10.1111/hex.13686
PMCID: PMC9854285
PMID: 36482826
Abstract
Shared decision-making, with an emphasis on patient autonomy, is often advised in healthcare decision-making. However, this may be difficult to implement in emergent settings. We have previously demonstrated that when considering emergent operations for their children, parents prefer surgeon guidance as opposed to shared decision-making. Here, we interviewed parents of paediatric patients who had undergone emergent operations to better understand parental decision-making preferences.
Parents of paediatric patients who underwent surgery over the past 5 years at a University-based, tertiary children's hospital for cancer, an emergent operation while in the neonatal intensive care unit (NICU) or extracorporeal membrane oxygenation (ECMO) were invited to complete a 60-min semi-structured interview. Interviews were digitally recorded and transcribed verbatim. Thematic content analysis was performed via deductive and inductive analysis. An iterative approach to thematic sampling/data analysis was used.
Thematic saturation was achieved after 12 interviews (4 cancer, 5 NICU and 3 ECMO). Five common themes were identified: (1) recommendations from surgeons are valuable; (2) 'lifesaving mode': parents felt there were no decisions to be made; (3) effective ways of obtaining information about treatment; (4) shared decision-making as a 'dialogue' or 'discussion' and (5) parents as a 'valued voice' to advocate for their children.
When engaging in decision-making regarding emergent surgical procedures for their children, parents value a surgeon's recommendation. Parents felt that discussion or dialogue with surgeons defined shared decision-making, and they believed that the opportunity to ask questions gave them a 'valued voice', even when they felt there were no decisions to be made.
For this study, we interviewed parents of paediatric patients who had undergone emergent operations to better understand parental decision-making preferences. Parents thus provided all the data for the study.
Details
- Title: Subtitle
- A valued voice: A qualitative analysis of parental decision-making preferences in emergent paediatric surgery
- Creators
- Erica M Carlisle - College of Medicine, Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa, USALaura A Shinkunas - University of IowaEmily Ruba - College of Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USACaleb J Klipowicz - University of IowaMaxwell T Lieberman - Department of Anthropology, University of Iowa, Iowa City, Iowa, USARichard M Hoffman - University of IowaHeather S Reisinger - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health expectations : an international journal of public participation in health care and health policy, Vol.26(1), pp.531-541
- DOI
- 10.1111/hex.13686
- PMID
- 36482826
- PMCID
- PMC9854285
- NLM abbreviation
- Health Expect
- ISSN
- 1369-6513
- eISSN
- 1369-7625
- Grant note
- UL1TR002537 / National Center for Advancing Translational Sciences of the National Institutes of Health
- Language
- English
- Electronic publication date
- 12/08/2022
- Date published
- 02/2023
- Academic Unit
- Medical Ethics; Stead Family Department of Pediatrics; Epidemiology; Surgery; Center for Social Science Innovation; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984322766802771
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