Factors influencing parent decision making about pediatric cardiac transplantation.

The purpose of this prospective qualitative study was to investigate factors that influenced 15 parental decision-making situations regarding pediatric heart transplantation for children with end-stage heart disease. Twenty-four parents of 15 children, ranging in age from 1 day to 16 years, who had been given the heart transplantation option were inducted into the study as a convenience sample. All 24 parents were either interviewed (n = 18) or observed at some point during the decision-making process. Data collection strategies included participant observation and in-depth interviews. Data were coded into relevant themes and then clustered into categories; concurrent coding and analysis continued until new categories were no longer found. Predominant factors identified that influenced parental decision making were (a) psychological/emotional, (b) familial, and (c) social factors, and (d) physician endorsement of a treatment option. In 10 of the 15 situations, family beliefs and values were the main parental decision-making factors. Ten families chose transplantation for their child; 5 decided against the procedure. Pediatric nurses have central roles in facilitating parent-health professional communication in complex decision making concerning treatment alternatives of children.