Priority 7 from the Paediatric Hospital Care PSP

UNCERTAINTY: What are effective ways to incorporate shared decision-making with parents and children/youth hospitalized on the general paediatric inpatient unit? ("Effectiveness” defined as length of stay, caregiver confidence) (JLA PSP Priority 7)
Overall ranking	7
JLA question ID	0114/07
Explanatory note	Children and family may feel they cannot participate in making decisions around the child's clinical care, as such it is important to understand ways to incorporate shared decision making
Evidence	Malone, H., Biggar, S., Javadpour, S., Edworthy, Z., Sheaf, G., & Coyne, I. (2019). Interventions for promoting participation in shared decision-making for children and adolescents with cystic fibrosis. The Cochrane database of systematic reviews, 5(5), CD012578. https://doi.org/10.1002/14651858.CD012578.pub2 Coyne, I., O'Mathúna, D. P., Gibson, F., Shields, L., Leclercq, E., & Sheaf, G. (2016). Interventions for promoting participation in shared decision-making for children with cancer. The Cochrane database of systematic reviews, 11(11), CD008970. https://doi.org/10.1002/14651858.CD008970.pub3 Kew, K. M., Malik, P., Aniruddhan, K., & Normansell, R. (2017). Shared decision‐making for people with asthma. Cochrane Database of Systematic Reviews, (10). Liverpool, S., Pereira, B., Hayes, D., Wolpert, M., & Edbrooke-Childs, J. (2020). A scoping review and assessment of essential elements of shared decision-making of parent-involved interventions in child and adolescent mental health. European child & adolescent psychiatry, 1-20. Wyatt, K. D., List, B., Brinkman, W. B., Lopez, G. P., Asi, N., Erwin, P., ... & LeBlanc, A. (2015). Shared decision making in pediatrics: a systematic review and meta-analysis. Academic pediatrics, 15(6), 573-583. Yamaji, N., Suto, M., Takemoto, Y., Suzuki, D., Lopes, K. D. S., & Ota, E. (2020). Supporting the decision making of children with cancer: a meta-synthesis. Journal of Pediatric Oncology Nursing, 37(6), 431-443.
Health Research Classification System category	Generic health relevance

Extra information provided by this PSP
Original uncertainty examples	Attention needs to be paid to treatment options that families want explored, whether conventional, complementary, or traditional in origin. ~ multiD handover and rounds how it is run and the best way to run to incorp family centered care. ~ 5) Do rounds that genuinely include parents shorten stays, increase the knowledge and confidence of parents at discharge, or help families participate more competently and confidently in the child's care? ~ Involving children and youth in decision making about their health and treatment, ~ Parental involvement with care while in hospital effects on outcomes. ~ 4) How can we better partner with families/caregivers for optimal and effective shared decision making . ~ How can parents and caregivers be better engaged in the process of discharge? ~ How much did patients understand about their hospitalization/discharge?
Submitted by	3 x physician, 2 x parent/caregiver, 2 x nurse

Extra information provided by this PSP

Original uncertainty examples

Attention needs to be paid to treatment options that families want explored, whether conventional, complementary, or traditional in origin. ~ multiD handover and rounds how it is run and the best way to run to incorp family centered care. ~
5) Do rounds that genuinely include parents shorten stays, increase the knowledge and confidence of parents at discharge, or help families participate more competently and confidently in the child's care? ~ Involving children and youth in decision making about their health and treatment, ~ Parental involvement with care while in hospital effects on outcomes. ~ 4) How can we better partner with families/caregivers for optimal and effective shared decision making . ~ How can parents and caregivers be better engaged in the process of discharge? ~ How much did patients understand about their hospitalization/discharge?

Submitted by

3 x physician, 2 x parent/caregiver, 2 x nurse

PSP information
PSP unique ID	0114
PSP name	Paediatric Hospital Care (Canada)
Total number of uncertainties identified by this PSP.	75 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	18th and 19th August 2021