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父母对不确定性的容忍度与儿科耳鼻喉外科学决策冲突的关系。

Relationship Between Parental Intolerance of Uncertainty and Decisional Conflict in Pediatric Otolaryngologic Surgery.

机构信息

Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

Department of Otolaryngology, UPMC Center for Cranial Base Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

出版信息

Otolaryngol Head Neck Surg. 2021 Aug;165(2):354-359. doi: 10.1177/0194599820973644. Epub 2020 Dec 8.

Abstract

OBJECTIVE

To assess the relationship between depression, anxiety, stress, worry, intolerance of uncertainty (IU), and shared decision making (SDM) in parents of pediatric otolaryngology surgical patients with their perceptions of decisional conflict (DC).

STUDY DESIGN

Cross-sectional.

SETTING

Academic pediatric otolaryngology outpatient clinic.

METHODS

Participants were legal guardians of pediatric patients who met criteria for otolaryngologic surgery. Participants completed a demographic survey as well as validated Decisional Conflict Scale (DCS); Shared Decision-Making Scale (SDMS); Depression, Anxiety and Stress Scale-21 (DASS-21); Penn State Worry Questionnaire (PSWQ); and short form of the Intolerance of Uncertainty Scale (IUS-12).

RESULTS

A total of 114 participants were enrolled. Respondents were predominantly female (93.0%) and married (60.5%). Most guardians had not consented previously for otolaryngologic surgery for their child (69.3%). Participants reported low levels of DC and depression as well as moderate levels of anxiety and stress. DC scores were not significantly correlated to DASS-21, PSWQ, or SDM. IUS-12 Total and subscale IUS-12 prospective negatively correlated with Total DC. DC was not related to age, sex, education level, previous otolaryngologic surgery, or type of surgery recommended.

CONCLUSION

In this group, an association was found between IU and DC. Clinicians should be aware that DC is not modified by previous surgical experience. Interventions aimed at addressing parental IU related to surgery may reduce DC. Further research efforts could help us understand how mental health relates to surgical decision making.

摘要

目的

评估儿科耳鼻喉外科手术患儿父母的抑郁、焦虑、压力、担忧、不确定性容忍度(IU)和共同决策(SDM)与他们对决策冲突(DC)的看法之间的关系。

研究设计

横断面研究。

设置

学术儿科耳鼻喉科门诊。

方法

参与者为符合耳鼻喉科手术标准的儿科患者的法定监护人。参与者完成了人口统计学调查以及经过验证的决策冲突量表(DCS);共同决策量表(SDMS);抑郁、焦虑和压力量表-21(DASS-21);宾夕法尼亚州担忧问卷(PSWQ);和不确定性容忍度量表 12 项短式量表(IUS-12)。

结果

共有 114 名参与者入组。受访者主要为女性(93.0%)和已婚(60.5%)。大多数监护人之前没有同意为孩子进行耳鼻喉科手术(69.3%)。参与者报告 DC 水平较低,抑郁程度较低,焦虑和压力程度中等。DASS-21、PSWQ 或 SDM 与 DC 评分无显著相关性。IUS-12 总分和 IUS-12 前瞻性子量表与总 DC 呈负相关。DC 与年龄、性别、教育程度、先前耳鼻喉科手术或推荐的手术类型无关。

结论

在这组人群中,发现 IU 与 DC 之间存在关联。临床医生应该意识到,以前的手术经验并不能改变 DC。针对与手术相关的父母 IU 进行干预可能会降低 DC。进一步的研究工作可以帮助我们了解心理健康与手术决策之间的关系。

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本文引用的文献

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Latent class analysis of indicators of intolerance of uncertainty.不确定性不耐受指标的潜在类别分析
Scand J Psychol. 2018 Jun;59(3):243-251. doi: 10.1111/sjop.12440. Epub 2018 Mar 26.
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Fear of the unknown: One fear to rule them all?对未知的恐惧:一种能统领一切的恐惧?
J Anxiety Disord. 2016 Jun;41:5-21. doi: 10.1016/j.janxdis.2016.03.011. Epub 2016 Mar 29.
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Understanding shared decision making in pediatric otolaryngology.理解小儿耳鼻喉科中的共同决策。
Otolaryngol Head Neck Surg. 2015 May;152(5):941-7. doi: 10.1177/0194599815574998. Epub 2015 Mar 20.

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