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

Background: The traditional paternalistic approach to medical decision-maki ng is moving towards a climate of greater patient and/or surrogate involvem ent. Despite this, there is considerable debate regarding patient preferenc es for participation in medical decisionmaking and its effect on patient sa tisfaction and outcome. This study was designed to examine parents' prefere nces for participation in decisions regarding their child's anaesthetic car e and to determine if active participation is associated with greater paren tal satisfaction. Methods: Three hundred and eight parents of children scheduled to undergo e lective surgical procedures were asked to complete a questionnaire detailin g information regarding their preferences for participation in decisions ma de regarding their child's anaesthetic care. Parents were classified as bei ng passive, shared, or active decision makers. Results: Overall, parents evidenced a preference for shared decisionmaking with the anaesthetist. Parents preferred to be passive with respect to intr aoperative pain management but active with respect to their presence when t heir child wakes up. There were no differences between active, shared and p assive 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 tha n those who felt that their participation had been adequate. Conclusions: This study highlights specific areas in which parents would pr efer a more active role in decision-making and, as such, may serve to focus anaesthetists' efforts to educate parents with respect to the various opti ons available for their child's care.