Objective: The purpose of the study was to determine if a co-payment resulted in a differential preference for general anesthesia (GA) or oral sedation (OS) and, if so, to examine whether age, the number of appointments, perceived risks of treatment, child's awareness during treatment, or insurance type appeared to play a role in this preference.Methods: Using a cross-sectional survey design, questionnaires were distributed to caregivers of patients in the waiting room of the Virginia Commonwealth University Pediatric Dental Clinic. Two different questionnaires were distributed randomly. Both surveys described a scenario with the need for dental treatment under general anesthesia (GA) or oral conscious sedation (OS). Seventy five surveys required a $50 co-payment for treatment completed under general anesthesia and the other 75 required the same co-payment for treatment completed under oral conscious sedation. Caregivers were asked to choose treatment modalities as well as to rate factors in their decision making including perceived risks and the number of dental visits. Results: Seventy seven survey respondents selected GA as their preferred treatment option for the described scenario. The other sixty six respondents chose OS sedation. For the insured population, the GA/OS odds ratio for the OS-co-payment group versus the GA-co-payment group was OR=2.21 (95% CI = 1.06, 4.60). In terms of the uninsured, the GA/OS odds ratio for the OS-co-payment group versus the GA-co-payment group was OR=17.5 (95% CI = 1.60, 191). The child's age, awareness during treatment, and type of insurance (public versus private) were not significantly related to treatment choice. The importance of the number of appointments was found to be significant (p-value = 0.0170) and outweighed the effect of the co-payment (p-value = 0.1757). The importance of associated risks was found to be significant (p-value = 0.0171) and this outweighed the effect of the co-payment (p-value = 0.8157).Conclusions: The presence of a co-payment does not as significantly impact the GA versus OS preference while the number of appointments and perceived risks associated with the treatment remain significant.

This study aimed to establish a connection, if any, between perceptions of information disclosure about medical treatment and decisional conflict in bereaved parents of children with cancer. Decisional regret was an important theme in this exploration because decisional conflict strongly aligns with the propensity to mentally redo past events, thereby forming counterfactual alternatives to reality. People generate counterfactuals to hypothesize a more favorable outcome subsequent to a negative event or the death of a child as applicable to this study. A secondary objective was to investigate the potential influence of counterfactual processing and regret on the construct of self-acceptance: a phenomenon researchers have rarely studied in the population of interest. Study participants included parents who lost a child to cancer in the United States after participating in medical treatment prescribed by a licensed oncologist. Cluster and convenience sampling were employed to recruit 92 participants. Quantitative methods were used in obtaining data samples through validated instruments for each independent and dependent variable. The responses collected indicate that a perceived lack of information disclosure about treatment risks and efficacy, yield a positive influence on decisional conflict after the death of a child. Similarly, decisional conflict positively correlates with decisional regret, while the latter negatively correlates with self acceptance in the bereavement process. The research implications call for additional studies that further isolate factors that contribute to decisional conflict. This study advocates for decision making tools and collaborative processes that ensure parents are well informed and involved in making medical decisions from diagnosis through palliative care, if a cure is not possible.