Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH, USA.
Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111143. doi: 10.1016/j.ijporl.2022.111143. Epub 2022 Apr 14.
Tonsillectomy use is lower among Black children than White children in the U.S. despite their higher prevalence of obstructive sleep disordered breathing (oSDB). We aimed to identify factors associated with parents' willingness to consider tonsillectomy for their child's oSDB and to identify whether parents of Black children are less willing than parents of non-Black children to be willing to consider the procedure.
Prospective cohort study.
Primary care network of a tertiary children's hospital.
We surveyed parents/guardians of children aged 2-10 years with oSDB, to assess their knowledge about oSDB and tonsillectomy, perceived severity of their child's oSDB, perceived level of their child's sleep disturbance, perceived risks and benefits of tonsillectomy, stress, trust in their child's primary care physician and physicians in general, and health literacy. We also assessed child clinical and sociodemographic characteristics. Associations between these characteristics and parent/guardian willingness to consider tonsillectomy for their child's oSDB were assessed.
Of the 59 parents/guardians included, 90% were mothers and 71% were Black. Only 58% of caregivers of Black children but 85% of caregivers of non-Black children were willing to consider tonsillectomy (p = 0.04). Caregivers with another child who had undergone tonsillectomy and caregivers who perceived their child's sleep to be more disturbed were more often willing to consider tonsillectomy (both p = 0.02).
Parents of Black children are less willing to consider tonsillectomy for their child's oSDB, but this was not explained by any factors assessed in this study. Future studies should evaluate additional factors that may explain this difference and that might be targeted to ensure appropriate and equitable access to tonsillectomy among children with oSDB.
尽管美国黑人儿童阻塞性睡眠呼吸暂停（obstructive sleep disordered breathing，oSDB）的患病率较高，但他们接受扁桃体切除术的比例却低于白人儿童。本研究旨在确定与父母愿意考虑为患有 oSDB 的孩子进行扁桃体切除术相关的因素，并确定黑人儿童的父母是否比非黑人儿童的父母更不愿意考虑该手术。
前瞻性队列研究。
三级儿童医院的初级保健网络。
我们调查了患有 oSDB 的 2-10 岁儿童的父母/监护人，以评估他们对 oSDB 和扁桃体切除术的了解程度、他们孩子 oSDB 的严重程度、他们孩子睡眠障碍的严重程度、他们对扁桃体切除术的风险和益处的感知、压力、对孩子的初级保健医生和一般医生的信任以及健康素养。我们还评估了儿童的临床和社会人口统计学特征。评估了这些特征与父母/监护人愿意为孩子的 oSDB 考虑扁桃体切除术之间的关联。
在 59 位父母/监护人中，90%是母亲，71%是黑人。只有 58%的黑人儿童的照顾者愿意考虑扁桃体切除术，而 85%的非黑人儿童的照顾者愿意考虑扁桃体切除术（p=0.04）。有另一个接受过扁桃体切除术的孩子的照顾者和认为孩子睡眠更受干扰的照顾者更愿意考虑扁桃体切除术（均 p=0.02）。
黑人儿童的父母更不愿意为孩子的 oSDB 考虑扁桃体切除术，但本研究评估的任何因素都无法解释这一差异。未来的研究应评估可能解释这种差异的其他因素，并可能针对这些因素，以确保患有 oSDB 的儿童能够获得适当和平等的扁桃体切除术机会。
