Experiences of decisional conflict in parents offered hip reconstructive surgery for their child with cerebral palsy.

Abstract

Using a mixed methods study to explore the level of parents' decisional conflict and decision-making experiences when offered hip surgery for their child with non-ambulant cerebral palsy (CP). Parents of children with non-ambulant CP who were offered hip surgery for their child's hip displacement, were surveyed and completed the Decisional Conflict Scale (DCS). Guided by the Ottawa Decision Support Framework, potential factors associated with decisional conflict were evaluated. Parents were approached to participate in a semi-structured interview guided by Interpretive Description to explore their decision-making experiences. Eleven parents completed the survey and 4 (36.4%) had DCS scores ≥ 25. Nine of 11 parents participated in semi-structured interviews. Themes included: Focus on Future Quality of Life; Processing Time; Necessity of Surgery; and the Importance of Information. Parents indicated key strategies to minimize uncertainty and support them in decision-making included providing ample deliberation time and understandable and accessible information with opportunities for questions. Approximately one-third of parents experience decisional conflict associated with the decision for hip surgery. Healthcare professionals can support parents by assisting parents to focus on their child's quality of life and goals of care while providing ample information and time for decision-making.