Decisional conflict levels and associated factors among parents of pediatric patients undergoing emergency gastric lavage: a cross‑sectional survey

Background: Decisional conflict—defined as a state of uncertainty and hesitation regarding the choice among alternative actions—can adversely affect decision quality, parental psychological well-being, and subsequent treatment adherence. While decisional conflict has been studied in elective and chronic care contexts, little is known about its magnitude and determinants in acute pediatric emergency procedures such as gastric lavage, where parents must make high-stakes decisions under extreme time pressure. This study aimed to assess the level of decisional conflict and identify its associated factors among parents of children undergoing emergency gastric lavage.

Methods: A cross-sectional survey was conducted among 266 parents of children who underwent emergency gastric lavage at a single tertiary children’s hospital between January 2025 and February 2026. Participants were recruited using convenience sampling. Data were collected with a self-developed, 20-item decisional conflict instrument designed for the emergency lavage context. The scale demonstrated good internal consistency (Cronbach’s α=0.902) and content validity [scale-level content validity index (CVI) =0.91]. Univariate analysis, correlation analysis, and multiple linear regression were performed.

Results: The mean age of the children was 4.2±2.8 years, and 69.2% of the parent respondents were mothers. The mean total decisional conflict score was 58.12±6.30 (standardized score 72.6±15.8), with 91.4% of parents exceeding the clinical threshold for significant conflict (standardized score ≥37.5). Multiple linear regression revealed that divorced/widowed/unmarried marital status (β=0.197, P<0.001), lower education level (β=−0.186, P=0.001), absence of a medical background (β=0.176, P=0.001), younger child age (β=−0.159, P=0.004), and lower family monthly income per capita (β=−0.155, P=0.009) were independently associated with higher decisional conflict. The model explained 30.9% of the variance. The “uncertainty and pressure” subscale had the highest mean item score (3.25±0.65).

Conclusions: Parents of children undergoing emergency gastric lavage experience a high level of decisional conflict, particularly those who are socioeconomically disadvantaged, lack medical knowledge, or have limited spousal support. Clinicians should implement tiered decision support strategies targeting these high-risk groups, such as assigning dedicated social workers or volunteer companions for non-married parents, providing plain-language illustrated decision aids for parents with lower educational attainment, and proactively addressing financial concerns for low income families.