Parents' preferences for participation in decisions made regarding their child's anaesthetic care.

BACKGROUND: The traditional paternalistic approach to medical decision-making is moving towards a climate of greater patient and/or surrogate involvement. Despite this, there is considerable debate regarding patient preferences for participation in medical decision-making and its effect on patient satisfaction and outcome. This study was designed to examine parents' preferences for participation in decisions regarding their child's anaesthetic care and to determine if active participation is associated with greater parental satisfaction.
METHODS: Three hundred and eight parents of children scheduled to undergo elective surgical procedures were asked to complete a questionnaire detailing information regarding their preferences for participation in decisions made regarding their child's anaesthetic care. Parents were classified as being passive, shared, or active decision makers.
RESULTS: Overall, parents evidenced a preference for shared decision-making with the anaesthetist. Parents preferred to be passive with respect to intraoperative pain management but active with respect to their presence when their child wakes up. There were no differences between active, shared and passive decision-makers with respect to their satisfaction with anaesthetic care and their participation in decision-making. However, 32.1% of parents stated that they would have preferred more involvement in decision-making. These parents were significantly less satisfied with their child's care than those who felt that their participation had been adequate.
CONCLUSIONS: This study highlights specific areas in which parents would prefer a more active role in decision-making and, as such, may serve to focus anaesthetists' efforts to educate parents with respect to the various options available for their child's care.