Hong Paul, Maguire Erin, Gorodzinsky Ayala Y, Curran Janet A, Ritchie Krista, Chorney Jill
IWK Health Centre, Halifax, Nova Scotia, Canada; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Int J Pediatr Otorhinolaryngol. 2016 Aug;87:39-43. doi: 10.1016/j.ijporl.2016.05.031. Epub 2016 May 20.
To describe physician and parent behavior during pediatric otolaryngology surgical consultations, and to assess whether perceptions of shared decision-making and observed behavior are related.
Parents of 126 children less than 6-years of age who underwent consultation for adeontonsillectomy or tympanostomy tube insertion were prospectively enrolled. Parents completed the Shared Decision-Making Questionnaire-Patient version (SDM-Q-9), while surgeons completed the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) after the consultation. Visits were video-recorded and analyzed using the Roter Interaction Analysis System to quantify physician and parent involvement during the consultation.
Perceptions of shared decision-making between parents (SDM-Q-9) and physicians (SDM-Q-Doc) were significantly positively correlated (p = 0.03). However, there was no correlation between parents' perceptions of shared decision-making and observations of physician and parent behavior/involvement (proportion of physician socioemotional talk, task-focused talk, or proportion of parent talk). Surgeons' perceptions of shared decision-making were correlated with physician task-focused talk and proportion of parent talk.
Parents and physicians had similar perceptions of the degree of shared decision-making to be taking place during pediatric otolaryngology consultations. However, there was variability in the degree to which parents participated, and parent perceptions of shared decision-making were not correlated with actual observed involvement.
描述小儿耳鼻喉科手术会诊期间医生和家长的行为，并评估共同决策的认知与观察到的行为之间是否存在关联。
前瞻性纳入126名6岁以下因腺样体扁桃体切除术或鼓膜置管术接受会诊的儿童的家长。家长完成《共同决策问卷 - 患者版》（SDM - Q - 9），而外科医生在会诊后完成《共同决策问卷 - 医生版》（SDM - Q - Doc）。会诊过程进行视频录制，并使用罗特互动分析系统进行分析，以量化会诊期间医生和家长的参与情况。
家长（SDM - Q - 9）和医生（SDM - Q - Doc）对共同决策的认知呈显著正相关（p = 0.03）。然而，家长对共同决策的认知与医生和家长行为/参与度的观察结果（医生社会情感谈话比例、任务聚焦谈话比例或家长谈话比例）之间没有相关性。外科医生对共同决策的认知与医生任务聚焦谈话和家长谈话比例相关。
家长和医生对小儿耳鼻喉科会诊期间共同决策程度的认知相似。然而，家长参与程度存在差异，且家长对共同决策的认知与实际观察到的参与情况无关。
