What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

Ellen A. Lipstein, William B. Brinkman and Maria T. Britto

Medical Decision Making, 2012, vol. 32, issue 2, 246-258

Abstract: Background. 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.

Keywords: randomized trial methodology; risk factor evaluation; population-based studies; scale development/validation; patient decision making; provider decision making; risk communication or risk perception; health state preferences, utilities, and valuations; judgment and decision psychology; informed consent; education; pediatrics (search for similar items in EconPapers)
Date: 2012
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:32:y:2012:i:2:p:246-258

DOI: 10.1177/0272989X11421528

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