Tarini Beth A, Christakis Dimitri A, Lozano Paula
University of Washington, Seattle, USA.
J Pediatr. 2007 Dec;151(6):690-5, 695.e1. doi: 10.1016/j.jpeds.2007.05.022. Epub 2007 Sep 17.
To determine parental participation in medical decision-making (MDM) during hospitalization and its association with parental self-efficacy and to explore other factors associated with participation.
We surveyed parents of children admitted to a pediatric medical unit to measure parental report of participation in MDM during hospitalization and self-efficacy with physician interactions (categorized into tertiles). We performed multivariate logistic regression to evaluate the association between self-efficacy and parental participation, controlling for potential confounders.
One hundred thirty of 278 eligible parents completed surveys and 86% reported participating in MDM about their child's care. After adjusting for covariates, parents with scores in the middle and highest self-efficacy tertiles had higher odds of participating in MDM compared with parents in the lowest tertile. Younger parents and parents of previously hospitalized children were also more likely to participate although parents with a high school education or less were less likely.
Self-efficacy was significantly associated with parental participation in MDM during hospitalization after adjusting for confounding factors. Interventions to increase self-efficacy may also improve parental participation in MDM.
确定住院期间父母参与医疗决策（MDM）的情况及其与父母自我效能感的关联，并探索与参与相关的其他因素。
我们对入住儿科病房的患儿家长进行了调查，以测量家长报告的住院期间参与医疗决策的情况以及与医生互动的自我效能感（分为三分位数）。我们进行了多变量逻辑回归，以评估自我效能感与父母参与之间的关联，并控制潜在的混杂因素。
278名符合条件的家长中有130名完成了调查，86%的家长报告参与了有关孩子护理的医疗决策。在对协变量进行调整后，自我效能感处于中等和最高三分位数的家长参与医疗决策的几率高于最低三分位数的家长。年轻家长以及孩子曾住院的家长也更有可能参与，不过高中及以下学历的家长参与的可能性较小。
在对混杂因素进行调整后，自我效能感与住院期间父母参与医疗决策显著相关。提高自我效能感的干预措施也可能改善父母对医疗决策的参与。
