Parental Attitudes Towards Choosing between Operative and Nonoperative Management of Pediatric Acute Appendicitis
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Read the article on jpedsurg.org ↗Article · Nov 2021 · 1 min read
In brief
In brief
Survey study of 45 parents offered choice between appendectomy or nonoperative management for pediatric acute appendicitis found that while half experienced more than minimal stress, 95% preferred making the decision themselves and maintained high satisfaction post-treatment. Findings support shared decision-making in pediatric surgical settings while highlighting need to identify and support parents experiencing decision-related stress.
Written by the GCMD Library team from the article.
Introduction
Making healthcare decisions for children can be challenging for parents or guardians. We aimed to characterize the decision-making preferences and stress of parents or guardians who were offered both appendectomy or nonoperative management (NOM) for children with acute appendicitis.
Methods
Criteria was developed for offering operative or NOM for patients. At the time of decision, parents or guardians completed a survey assessing their understanding of treatment options, stress and preferences in being given the choice. An outpatient follow-up survey was later administered to evaluate post-decision satisfaction.
Results
A total of 45 respondents were included in the study. Over 95% endorsed understanding of the risks/benefits of the options and felt supported and satisfied with their decision. Half felt the process was more than minimally stressful, 77% felt the decision was easy to make, 89% liked being asked and 95% preferred to make the decision themselves with varying degrees of input from their physician. Of the 62% of parents or guardians who completed the follow-up survey, >90% were satisfied with their decision and one respondent regretted their choice.
Discussion
When offered the choice between operative and NOM of acute appendicitis, half of parents or guardians felt greater than minimal stress. The majority endorsed adequate understanding of the options, felt it was an easy decision, and maintained the desire to be the primary decision maker for their child. Our study provides preliminary data on parental or guardian attitudes towards shared decision-making in the surgical setting. Follow-up studies should focus on identifying predictors for those who feel increased stress and difficulty with decision-making.