Introduction: Dysfunctional voiding is a common referral to pediatric urology. Treatment can involve a variety of options, including cognitive, behavioral, physical and pharmacologic therapies. Understanding the mechanism of dysfunctional voiding and the treatment options that may work best for their child can be confusing for parents. We hypothesized that use of an educational video would improve perceived parent involvement in understanding of the diagnosis and participation in decision making for their child.
Methods: Patients seen in the urology clinic for initial consultation for dysfunctional voiding between November 2019 – June 2021 were included. Approximately half of the patients were randomly assigned to intervention (2-minute video on voiding dysfunction) or to standard care (no video). The SDM-Q-9, a validated 9-question shared-decision-making survey, was administered at the end of the visit. Demographic information was collected via electronic health record.
Differences in central tendency were evaluated in item and composite score between treatment assignment, gender, race/ethnicity and ethnicity/language using the non-parametric Kruskal-Wallis test.
Results: A total of 98 participants were included in analysis, of whom 45.4% (44/98) were assigned to the video cohort and 54.6% (53/98) were assigned to standard care. 64.3% (63/98) of participants were female and 35.7% (35/98) of participants male. 50.0% (49/98) of patients identified as white non-Hispanic, 27.6% (27/98) identified as Hispanic, and 22.4% (22/98) of patients had other or unknown self-identified ethnicity.
Median aggregate SDM-Q-9 scores in the video cohort were higher than those without video, although this was not significant (98.9 vs 95.6, p = 0.49). Female gender (100 vs 95.6, p = 0.49) and self-identified ethnicity (100 vs 97.8 vs 85.6, p = 0.24) were not significantly associated with SDM-Q-9 aggregate scores. There was a significant difference in responses by ethnicity as to whether their provider explained the advantages and disadvantages of treatment options (p = 0.031).
Conclusions: In this study, we found that parents who watched a 2-minute educational video on dysfunctional voiding before initial consultation aggregately rated being more involved with shared decision making but this was not significant. Sex and ethnicity did not significantly impact aggregate shared decision-making scores. Our findings suggest that an educational video alone may not significantly impact shared decision-making for treatment of dysfunctional voiding.
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