Med Decis Making - What is known about parents' treatment decisions? A narrative review of pediatric decision making.

Tópicos

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Resumo

CKGROUND: With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process.OBJECTIVE: To conduct a narrative review of the current research on parent decision making about pediatric treatments and identify areas in need of further investigation.METHODS: Articles presenting original research on parent decision making were identified from MEDLINE (1966-6/2011), using the terms "decision making," "parent," and "child." We included papers focused on treatment decisions but excluded those focused on information disclosure to children, vaccination, and research participation decisions.RESULTS: We found 55 papers describing 52 distinct studies, the majority being descriptive, qualitative studies of the decision-making process, with very limited assessment of decision outcomes. Although parents' preferences for degree of participation in pediatric decision making vary, most are interested in sharing the decision with the provider. In addition to the provider, parents are influenced in their decision making by changes in their child's health status, other community members, prior knowledge, and personal factors, such as emotions and faith. Parents struggle to balance these influences as well as to know when to include their child in decision making.CONCLUSIONS: Current research demonstrates a diversity of influences on parent decision making and parent decision preferences; however, little is known about decision outcomes or interventions to improve outcomes. Further investigation, using prospective methods, is needed in order to understand how to support parents through the difficult treatment decisions.

Resumo Limpo

ckground increas complex decis pediatr medicin grow need understand pediatr decisionmak processobject conduct narrat review current research parent decis make pediatr treatment identifi area need investigationmethod articl present origin research parent decis make identifi medlin use term decis make parent child includ paper focus treatment decis exclud focus inform disclosur children vaccin research particip decisionsresult found paper describ distinct studi major descript qualit studi decisionmak process limit assess decis outcom although parent prefer degre particip pediatr decis make vari interest share decis provid addit provid parent influenc decis make chang child health status communiti member prior knowledg person factor emot faith parent struggl balanc influenc well know includ child decis makingconclus current research demonstr divers influenc parent decis make parent decis prefer howev littl known decis outcom intervent improv outcom investig use prospect method need order understand support parent difficult treatment decis

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