背景:在美国儿科泌尿科诊所中,包皮环切术的要求很常见。因为父母是孩子的代理决策者,有几种影响可能会影响父母支持或反对包皮环切术的决定。
目的:我们试图评估父母对孩子的包皮环切状态的遗憾,并将遗憾与可能影响最初决定的因素联系起来。
方法:从2023年3月到2024年1月,我们调查了出于任何原因将男性孩子带到我们办公室的父母,独立于包皮环切状态。问卷是双重的:经过验证的决策后悔量表(DRS)(0-100,其中较高的分数=较高的后悔)以及我们关于其决策过程和结果的问题。遗憾分数是每个独立决策和结果变量的函数。
结果:总体而言,未包皮环切术和包皮环切术父母组的决策后悔评分均呈正偏差,中位数为0,平均22,范围为0~75.对于那些包皮环切术(n=91),中位后悔评分为0(IQR0-25).对于那些未割礼的人(n=28),中位后悔评分为0(IQR0-24).总的来说,两组中有55%的人报告没有遗憾(DRS=0),24%有低轻度后悔(DRS5-25),21%产生中强后悔(DRS30-100)。认为自己做出了明智决定或得到任何医生建议的父母的后悔得分较低。提出与孩子未割礼或割礼阴茎相关问题的父母(DRS评分分别为37.5和25)的遗憾评分较高。
结论:我们发现,很大一部分父母对他们的孩子接受或不接受包皮环切术的决定没有遗憾(55%)。父母组之间的中位后悔得分也没有差异。然而,很大一部分父母确实表达了中度-重度后悔(21%),一些影响因素与后悔评分相关.这些因素包括明智的决策,医生咨询,外观满意度,以及与孩子的包皮环切或未包皮环切的阴茎有关的问题。这些因素得到了使用DRS和人口研究的其他文献的支持。我们研究的局限性包括参与者的有限招募和潜在的时间依赖性反应偏差。
结论:五分之一的包皮环切和未包皮环切男孩的父母对我们儿科泌尿科诊所的新生儿包皮环切的决定表示中度至强烈的遗憾。我们的数据表明,确保父母在决定新生儿包皮环切术之前有足够的咨询很重要。
BACKGROUND: Requests for circumcision revision are common in our American pediatric urology clinic. As parents are the surrogate decision maker for their child, there are several influences that can impact a parent\'s decision for or against circumcision.
OBJECTIVE: We sought to assess parents\' regret regarding their child\'s circumcision status and to correlate regret to factors that might have affected the original decision.
METHODS: From March 2023 to January 2024, we surveyed parents who brought their male child to our office for any reason, independent of circumcision status. The questionnaire was two-fold: a validated Decisional Regret Scale (DRS) (0-100 where higher scores = higher regret) and our questions regarding their decision-making process and outcome. Regret scores served as a function of each of the independent decision making and outcome variables.
RESULTS: Overall, decisional regret scores from both uncircumcised and circumcised parent groups were positively skewed with a median 0, mean 22, and ranged from 0 to 75. For those circumcised (n = 91), the median regret score was 0 (IQR 0-25). For those uncircumcised (n = 28), median regret score was 0 (IQR 0-24). Overall, 55% of both groups reported no regret (DRS = 0), 24% had low-mild regret (DRS 5-25), and 21% yielded moderate-strong regret (DRS 30-100). Parents who felt they made an informed decision or were counseled by any physician had lower regret scores. Parents who presented for issues related to their child\'s uncircumcised or circumcised penis (DRS score 37.5 and 25 respectively) had higher regret scores.
CONCLUSIONS: We found that a large portion of parents expressed no regret regarding their decision to have or not have their child circumcised (55%). There also was no difference in median regret scores between parent groups. However, a significant portion of parents did express moderate-strong regret (21%) and several influential factors were correlated with regret scores. These factors included informed decision making, physician counseling, appearance satisfaction, and problems related to their child\'s circumcised or uncircumcised penis. These factors are supported by other literature using the DRS and population studies. The limitations of our study included the limited recruitment of participants and potential time dependent bias of responses.
CONCLUSIONS: One in five parents of both circumcised and uncircumcised boys expressed moderate to strong regret regarding their decision about neonatal circumcision in our pediatric urology clinic. Our data suggests that ensuring parents have sufficient counseling prior to a decision regarding neonatal circumcision is important.