Parental perceptions and understanding of information provision, management options and factors influencing the decision-making process in the treatment of children with glue ear

Gkiousias, Vasileios, Butler, Christopher Collett, Shepherd, Victoria, Kilgour, James Michael, Waldron, Cherry-Ann, Thomas-Jones, Emma and Francis, Nicholas (2016) Parental perceptions and understanding of information provision, management options and factors influencing the decision-making process in the treatment of children with glue ear. International Journal of Pediatric Otorhinolaryngology, 89, 6-12. (doi:10.1016/j.ijporl.2016.07.021).

Abstract

Objectives Otitis media with effusion (OME) is a common cause of hearing loss and possible developmental delay in children, and there are a range of ?preference sensitive? treatment options. We aimed to evaluate the attitudes and beliefs of parents of affected children to treatment options including watchful-waiting, hearing aids, grommets, and, oral steroids with the intention of developing our understanding of decision-making and the factors influencing it, sources of parental information, and satisfaction with information provision. Design We recruited a convenience sample of twelve parents of eleven children with OME at a single ENT department of a teaching hospital into a qualitative research study. The children of the parents interviewed had already been recruited into the Oral Steroids for the Resolution of Otitis Media with effusion In Children (OSTRICH) study. Semi structured interviews were audio recorded, transcribed and then coded using an inductive, thematic approach. Results Parents were satisfied with the verbal provision of information during the treatment consultation, although many were keen to receive supplementary printed information. Discussion with family and friends helped the decision-making process, whereas insufficient information and a paternalistic approach were viewed as obstacles. Parents were particularly influenced by the following: the immediacy of the treatment option effect, perceived efficacy, perceived risks and adverse effects, social implications (especially with hearing aids) and past personal and informant experience. Conclusions Parents appreciate clinicians tailoring information provision to parents' information needs and preferred format. Clinicians should also elicit parental attitudes towards the different management options for OME and the factors influencing their decisions, in order to optimise shared-decision making and ultimately provide a better standard of clinical care.

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Contributors

Author: Nicholas Francis

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