Crossroads of parental decision making: Intersections of hope, communication, relationships, and emotions

Parents of children born with complex life-threatening chronic conditions (CLTCs) experience an uncertain trajectory that requires critical decision making. Along this trajectory, hope plays an influential but largely unexplored role; therefore, this qualitative descriptive study explores how parent and provider hope may influence decision making and care of a child born with CLTCs. A total of 193 interviews from 46 individuals (parents, nurses, physicians, and nurse practitioners) responsible for the care of 11 infants with complex congenital heart disease (CCHD) were analyzed to understand how hope features in experiences related to communication, relationships, and emotions that influence decision making. Overall, parental hope remained strong and played a pivotal role in parental decision making. Parents and professional healthcare providers expressed a range of emotions that appeared to be integrally linked to hope and affected decision making. Providers and parents brought their own judgments, perceptions, and measure of hope to relationships, when there was common ground for expressing, and having, hope, shared decision making was more productive and they developed more effective relationships and communication. Relationships between parents and providers were particularly influenced by and contributory to hope. Communication between parents and providers was also responsible for and responsive to hope.

Saudi Parents' Knowledge and Attitude towards Pediatric Organ Donation in Al-Riyadh, Kingdom of Saudi Arabia

Background: Organ donation is a life-saving process of removing an organ or tissue surgically from one person (the organ donor) and placing it into another person (the recipient). As well as The demand for organ donation is increasing over time Thus, understanding the attitudes and beliefs associated with parental decision making improve the rate of transplantation. Aims: To Evaluate the perception of Saudi parents towards pediatric organ donation, and to assess the role of cultural and religious beliefs in the parental decision-making regarding organ donation, and to discover the misconceptions leading to the refusal of organ donation. Methods: A cross-sectional study was conducted in Riyadh region from 1 July 2020 to 31 August 2020 among all Saudi parents aged 18-60 years in Riyadh at the kingdom of Saudi Arabia via an online questionnaire, the responses were Statistically analysis using R v 3.6.3. The mean ±standard deviation was used to summarize the distribution of continuous variables. Chi-square test of independence was used to assess the association between categorical variables. Linear regression was used to assess factors associated with knowledge regarding organ donation. Results: Among 588, the majority of responses, female 91.5%, showed that better education was associated with knowing about organ donation in children, with 60.7% of respondents who completed university education reporting so compared to 49.6% of those who completed high school education or more minor. Socio-economic status showed a statistically significant association with knowledge score (B = 0.36, P < 0.05). Moreover, higher education level showed a statistically significant association with accepting organ donation from one’s child (OR = 1.77, P = 0.05), in contrast to age, gender, and the number of children were not associated with organ donation acceptance. Respondents who did not think organ donation was permissible in Islam were less likely to accept organ donation than respondents who believed it was permissible (OR = 0.05, P < 0.001). More than half of the respondents heard about organ donation for children after death. At the same time, less than half of the respondents knew the correct definition for brain death. Only 34.7% of respondents knew that organ donation is allowed starting from birth. Most respondents knew about the possible organs to donate except for the lung. In addition, 45% of the respondents are either agreed or strongly agreed to discuss organ donation with their partner if they faced child loss. Conclusion: This study found a lack of knowledge regarding organ donation among parents and impressively shows that the parents are willing to discuss organ donation if they face child loss. There was an urgent need to introduce campaigns focussing on awareness of child organ donation, including the protocol used in Saudi Arabia, especially among low socioeconomic status and who do not know Islam permission.

Vaccine hesitancy and implications on childhood immunisation in Malaysia

PurposeThe World Health Organization identified vaccine hesitancy as one of the ten threats to global health in 2019. The purpose of this paper is to evaluate the implications and factors affecting parental decision on childhood immunisation in Malaysia.Design/methodology/approachThis paper reviews literature on vaccine hesitancy and evaluation of factors affecting parental decision on childhood immunisation in Malaysia.FindingsVaccine hesitancy is a growing public health concern in Malaysia with factors such as influence of Internet and social media, personal choice and individual right, conspiracy theory, religious reasons and alternative medicine as among the influencing dynamics. An urban, educated demography operating within a postmodern medical paradigm compounds the diminishing value of vaccines.Originality/valueThis paper provides a comprehensive examination of vaccine hesitancy in Malaysia. Critical appraisal on personal choice over societal responsibility within an Asian/Muslim collectivist society has not been discussed in previous studies. The acceptance of homeopathy as an Islamic medicine alternative is peculiar to multi-ethnic, multi-cultural Malaysia.

Parental Decision Regret after Consenting to or Refusing Hypospadias Repair: an Australian Survey

Background: Parental decision regret in hypospadias surgery is a recognised source of long-lasting psycho-social morbidity. Its reported prevalence is high but until now, it has not been studied in Australasian context or among parents who declined the repair for their son. The aim of this study is to report on decision regret in an Australian cohort of parents, including parents who accepted or who declined repair for their son and explore underlying factors for decision-making, satisfaction, and regret. Methods: An online anonymous survey was administered to three groups: 1) parents who consented for hypospadias repair, 2) parents who declined repair and 3) a control group who requested circumcision for their child. Operations occurred between 2010 and 2020. The survey included a validated decision regret assessment tool and additional questions to explore the possible basis of the opinions. Results: One hundred and eighteen parents (eligible 381, response rate 31%) participated. Decision regret was present in group 1 (n=89) – 55% (moderate-to-severe 15%), in group 2 (n= 14) – 71% (moderate-to-severe 57%), and in the control group (n=15) – 15% (moderate-to-severe 8%) of parents. There was a significant difference in the median decision regret score between all three groups. Parents who chose hypospadias repair were mostly concerned about function. They named the direction of the urine from the tip of the penis as the most satisfying outcome, and the appearance of the foreskin and the need for several operations as the least satisfying outcomes of the repair. Conclusions: The prevalence of decision regret among Australian parents who consented for their son’s hypospadias repair was lower compared with the mean decision regret reported in the literature to date (55% vs 65%). Decision regret and its severity were highest among parents who declined hypospadias repair. New strategies are needed to reduce decision regret in parents whether or not they elect for surgery.

Namere o vakcinisanju dece protiv kovida-19: verodostoјnost informaciјa i emocionalno-kognitivna pobuđenost

The parental decision to vaccinate children presents a specific cognitive and emotional challenge, which is further aggravated by the conditions of the Kovid-19 epidemic and the general discourse on vaccination. It is estimated that the first vaccines for children against Covid-19 will be available in early 2022. In this study, we examined whether emotional-cognitive alertness (ECA) as a consequence of life circumstances due to the epidemic, the assessed credibility of information (CI) from various sources, which is the basis of trust, as well as the general attitude about vaccinating children unrelated to Covid-19, form intentions to vaccinate a child against Kovid-19. The results indicate that the general attitude towards vaccination and ECA are the strongest predictors of the intention to vaccinate a child. This intention is not influenced by the estimated CI representatives of public health, and the connection with the physicians' CI is negative. The epistemic authorities which traditionally represent one of the main supports for parents when deciding on vaccination have an altogether weaker impact than expected.