Parents' Participation In Medical Decisions Linked To Self-efficacy

In a new study published in the October issue of the Journal of Pediatrics, 86 percent of parents report that they participate in decisions made about their hospitalized child's medical care. Researchers also found that parents who feel confident communicating with physicians -- as well as those parents whose child has been previously hospitalized -- are more likely to participate in medical decisions.

The role of parents as participants in medical decisions may significantly affect the child's health, says study lead author Beth A. Tarini, M.D., clinical lecturer and member of the Child Health Evaluation Research (CHEAR) Unit in the Division of General Pediatrics at Mott. She notes that previous research has shown that in adult patients, shared decision- making -- between patients and health care providers --improves health outcomes.

"Medical care has become more complex, and it behooves us to get parents more involved in that care," says Tarini. "Ultimately, parents are responsible for the care of their child once they leave the hospital. When parents feel informed and empowered, they're likely to be better prepared to care for their child."

For the study, Tarini and her colleagues surveyed parents of children admitted to the general pediatrics ward of a children's hospital in Seattle during a two-month period. All parents surveyed had children younger than 18, and were given the survey within 24 to 48 hours of admission to the hospital, after the parents had met with physicians and other medical staff to discuss their child's care.

The self-administered survey, available in English and Spanish, asked 130 parents general questions about their hospital experience in order to evaluate their participation in medical decision-making during their child's hospitalization.

The study revealed that parents' ability to make medical decisions about their child was strongly linked to self-efficacy, or confidence in their ability to interact and communicate with physicians.

Additionally, researchers also found that parents of previously hospitalized children were more involved in medical decision-making. Tarini says this finding suggests that the hospital may be "a learned experience" for parents.

"While this study is only the first step to learning more about parental participation in medical decisions, it is a reminder to physicians of the potential modifiability of parents' involvement in their child's medical care," says Tarini.

According to Tarini, the next phase of research on this topic will involve working to determine if parental participation in medical decisions improves medical outcomes for the child.

Tarini conducted this study while she was a Robert Wood Johnson Clinical Scholar at the University of Washington. Her co-authors from the Child Health Institute and Children's Hospital and Regional Medical Center in Seattle are Dimitri A. Christakis, M.D., MPH, Division of General Pediatrics, University of Washington; and Paula Lozano, M.D., MPH, Center for Health Studies, Group Health Cooperative.

Funding for the study was provided by a grant from the Quality Improvement Committee at Children's Hospital and Regional Medical Center in Seattle.

Reference: Journal of Pediatrics, October 2007, Vol. 151, issue 4.