Needs assessment of parents for a patient decision aid in pediatric interval appendectomy via the qualitative interview method

Objectives Appendicitis is one of the most commonly encountered pediatric surgical diagnoses,with non-operative management of perforated appendicitis leading to two treatment options:an interval appendectomy(IA)or expectant management.The primary objective of this study was to assess parents'need for a patient decision aid(PDA)among parents considering IA or expectant management.A secondary objective was to determine parent preferences for the format and distribution plan of a drafted patient decision aid.Methods Coulter's systematic development process for PDA was used to guide the assessment interviews for parents.Participants included caregivers of a patient who experienced perforated appendicitis,and admission between 2019 and 2020.Semi-structured individual interviews were conducted to collect information about decision-making needs of parents of children who experienced perforated appendicitis.Results A total of 12 different parents participated in the interviews.Results indicate decisional conflict associated with the lack of evidence for optimal treatment,supporting the need for the development of a patient decision aid to assist in clarifying information and parent values with practitioners.Parents clearly identified a need for evidence to support decision-making in various formats(eg,pamphlet or electronic).Timing of when to deliver the PDA varied(ie,during hospital admission,at discharge,or at follow-up appointment).Conclusion Results indicated various factors contributing to parental decisional conflict,including the lack of evidence showing the optimal treatment,the need for more information,and guidance from practitioners.Overall,findings indicate a strong need for a patient decision aid.