Development of a patient decision aid for pediatric interval appendectomy
Quality and Safety
CHA-17-006 To the best of our knowledge, our team is developing the first patient decision aid (PtDA) in the field of pediatric surgery, specifically for the decision on elective interval appendectomy.This research integrates results from our previous systematic review, as well as stakeholder collaboration in PtDA research. Findings from the needs assessment phase have shown this product is desirable to families. As perforated appendicitis is a common presentation in children, a large population would benefit from this tool. Several families as stakeholders are involved throughout the conception, development, and testing of the decision aid. It is expected that this involvement will facilitate the implementation and uptake of the final product. This project will also allow us to determine if end-users of pediatric decision aids value contributing to this line of research, as we have long-term intentions of creating PtDAs for a variety of pediatric surgical conditions.
CHA-17-006 Patients and families faced with the decision of elective surgery for perforated appendicitis may face decisional conflict. The purpose of this study is to conduct a needs assessment for a patient decision aid (PtDA) to assist families in the decision-making process. Semi-structured individual interviews were conducted to investigate decisional needs of families who are in the treatment decision-making process or who have already made the decision. 13 interviews were conducted with 12 families. Transcripts were analyzed using the constant comparative approach. Four families were uncertain about the decision, 4 opted for elective surgery, and 4 decided on a conservative approach. The vast majority families expressed decisional conflict and all strongly believed a decision aid would have been useful in their decision-making experiences. Features of a useful PtDA included general information on the condition, prognosis, treatment options (risks and benefits), recovery information, symptoms of recurrence, and a guide to decision-making. Many expressed the desire for visual graphics to keep content simple. Timing for when the PtDA should be delivered varied, with preferences ranging from during hospital admission to at the 6 week follow-up appointment. Overall, results indicate a strong need for a patient decision aid. Next steps will be reviewing the results with the steering committee (experts and family stakeholders) and CHEO’s Family Advisory Council (FAC) to oversee the development of the draft will be piloted amongst patients and families for additional feedback.