Outpatient parents’ views on shared-decision-making at an Italian children’s hospital

• Published in: Health promotion international Vol. 33; no. 4; pp. 572 - 579
• Main Authors: Rosati, Paola, Di Salvo, Viviana, D’Amico, Roberto, Balduzzi, Sara, Giampaolo, Rosaria, Mazziotta, Mercedes Rita Marina, Guerra, Cesare, Menichella, Giovanna, Cosentino, Stefania P., Carlino, Cecilia, Di Ciommo, Vincenzo
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-08-2018
• Subjects: Cross-Sectional Studies; Culture; Decision Making; Female; Hospitals, Pediatric; Humans; Italy; Male; ORIGINAL ARTICLES; Outpatients; Parents - psychology; Professional-Family Relations; Surveys and Questionnaires; Italy
• ISSN: 0957-4824; 1460-2245
• DOI: 10.1093/heapro/daw105

Information is lacking on what parents in southern European countries know and how they view clinical shared-decision-making (SDM) for their children. This survey assesses general parental views on SDM and patient-physician SDM relationships in an Italian paediatric outpatients’clinic. In a 3-month cross-sectional survey, we enrolled 458 consecutive native and foreign Italian-speaking parents bringing their children to our public hospital for various reasons. Parents completed an anonymous questionnaire exploring their general views on SDM, including what doctor-patient relationship predominates today, and what approach reassures them most. Multivariate logistic regression analysed outcome data from parental questionnaire answers. Results are reported as percentages, odds ratios (OR) and 95% confidence intervals (CI). Multivariate logistic regression showed that 440 parents (96.1%) appreciated SDM, 245 (53.5%) preferred SDM for choosing children’s treatment, 126 (27.5%) answered that SDM is the predominant relationship today, and most parents 275 (60.0%) felt reassured by SDM. More native than foreign Italian-speaking parents preferred SDM (97.0 vs 89.7%, OR = 3.8; 95% CI = 1.4–10.8). Highly-educated parents preferred SDM for choosing their child’s therapy (57.9 vs 34.1%, OR = 2.7; 95% CI = 1.6–4.4) and this approach reassured them (64.3 vs 41.2%, OR = 2.5; 95% CI = 1.6–4.1). In conclusion, parents bringing children to an Italian outpatient clinic, especially highly-educated parents, wish to be offered SDM and find it reassuring. These findings should encourage paediatricians working in a challenging multicultural environment to change their physician-centred approach and engage parents in tailored SDM strategies.