gms | German Medical Science

19. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

30.09. - 01.10.2020, digital

Shared decision making in pediatrics and its association with satisfaction with care

Meeting Abstract

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  • Michael Eichinger - Medical Faculty Mannheim, Heidelberg University, Mannheim Institute of Public Health, Social and Preventive Medicine
  • Tatiana Görig - Medical Faculty Mannheim, Heidelberg University, Mannheim Institute of Public Health, Social and Preventive Medicine
  • Sabine Georg - Medical Faculty Mannheim, Heidelberg University, Mannheim Institute of Public Health, Social and Preventive Medicine
  • Freia De Bock - Medical Faculty Mannheim, Heidelberg University, Mannheim Institute of Public Health, Social and Preventive Medicine

19. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 30.09.-01.10.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. Doc20dkvf120

doi: 10.3205/20dkvf120, urn:nbn:de:0183-20dkvf1202

Veröffentlicht: 25. September 2020

© 2020 Eichinger et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: Shared decision making (SDM) contributes to the quality of care for children with chronic health conditions or disabilities and their parents. Contrary to healthcare services for adult patients, little is known about the extent of SDM in pediatrics, correlates of SDM that could be targeted by interventions to strengthen SDM, and to what extent SDM is associated with satisfaction with care.

Objectives: The objectives of this study therefore were

0.
to assess the extent of SDM with children with chronic health conditions or disabilities and their parents,
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to identify correlates of SDM and
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to investigate associations between SDM and satisfaction with care.

Methods: The study is based on baseline data of the cluster randomized PART-CHILD trial that is currently conducted in 15 German Social Pediatric Centers (SPC). A randomly selected sample of patients aged 7 years and older and their parents were included in the data collection. Participating families completed a paper-and-pencil questionnaire immediately after their appointment at the SPC. SDM and satisfaction with care were assessed using the child and parent versions of collaboRATE-pediatric (binary outcome, 1=optimal level of SDM) and the short form of CHC-SUN (range: 6–30; high values=high degree of satisfaction), respectively. Furthermore, the following covariates were assessed: age and gender of patients, type of condition and type of healthcare staff (e.g., physician, physiotherapist). Generalized linear mixed models were used to assess multivariable associations.

Results: In total, 242 patients and 844 parents were included in the analyses. While 58% of parents reported an optimal level of SDM only 38% of pediatric patients were highly satisfied with the current level of SDM. Female patients and their parents were more likely to report optimal levels of SDM than male patients and their parents (female patients: OR 1,5, 95% CI [1,1–2,3], p=0,03; parents of female patients: OR 1,3 [1,0–1,7], p=0,05). However, none of the other covariates were associated with SDM. After controlling for covariates SDM was positively associated with satisfaction with care for both pediatric patients and parents (pediatric patients: β=3,5 [2,5-4,5]; parents: β=4,0 [3,5–4,5]; p<0,001).

Discussion: Parents reported optimal levels of SDM more often than pediatric patients and female patients and their parents were more often highly satisfied with the implementation of SDM than male patients and their parents. Future studies should therefore investigate ways to specifically strengthen SDM with pediatric patients. If gender differences are consistently reported across different study settings, gender-sensitive strategies to improve SDM might be required. Moreover, SDM in SPC was associated with satisfaction with care for both pediatric patients and parents. Future studies should investigate the stability and causal nature of this association across different healthcare settings using longitudinal or experimental study designs.

Practical implications: Given that almost two thirds of pediatric patients and approximately 40% of parents report non-optimal levels of SDM effective interventions to strengthen the implementation of SDM in routine care are urgently needed.