Parental acceptability of the watchful waiting approach in pediatric acute otitis media

Table 1 Characteristics of the groups of parents enrolled n (%)

Characteristic	Total	Center A	Center B	Center C	Center D
	n = 600	n = 150	n = 150	n = 150	n = 150
Enrolled parent
Mother	414 (69)	105 (70)	96 (64)	116 (77)	97 (65)
Father	186 (31)	45 (30)	54 (36)	34 (23)	53 (35)
Mother age
20-30 yr	150 (36)	44 (42)	42 (44)	36 (31)	28 (29)
31-40 yr	214 (52)	53 (51)	48 (50)	65 (48)	57 (59)
> 40 yr	50 (12)	8 (7)	6 (6)	24 (21)	12 (12)
Father age
20-30 yr	31 (17)	5 (11)	14 (26)	5 (15)	7 (13)
31-40 yr	116 (62)	35 (78)	30 (56)	16 (47)	35 (66)
> 40 yr	39 (21)	5 (11)	10 (18)	13 (38)	11 (21)
Working mothers	316 (76)	82 (78)	75 (78)	86 (74)	73 (75)
Housewives	98	23 (22)	21 (22)	30 (26)	24 (25)
Working fathers	171	41 (91)	51 (94)	30 (88)	49 (92)
Unemployed fathers	15 (8)	4 (9)	3 (6)	4 (12)	4 (8)
Parental education
< high school	13	2 (1)	0	6 (4)	5 (3)
High school	278	68 (45)	54 (36)	88 (59)	68 (45)
College	209	55 (37)	62 (41)	42 (28)	50 (34)
> college	100	25 (17)	34 (23)	14 (9)	27 (18)
Parental past experience with otitis
Yes	411	112 (75)	101 (68)	100 (67)	98 (65)
Not	181	37 (25)	47 (31)	48 (32)	49 (33)
“I don’t know”	8	1 (1)	2 (1)	2 (1)	3 (2)

Table 2 Parental knowledge on acute otitis media treatment n (%)

CCCCC treatment/statement	Total	Center A	Center B	Center C	Center D
	n = 600	n = 150	n = 150	n = 150	n = 150
Antibiotics1	332 (56)	82 (55)	100 (60)a	74 (50)a	76 (51)
Ear drops1	147 (25)	55 (37)	26 (17)	31 (21)	35 (23)
Tympanocentesis1	26 (4)	4 (2)	2 (1)	9 (6)	11 (8)
Paracetamol1	6 (1)	0	3 (2)	2 (1)	1 (1)
Homeopathic drops1	20 (3)	0	7 (4)	6 (4)	7 (4)
No need to treat	14 (2)	0	4 (2)	5 (3)	5 (3)
“I don’t know”	55 (9)	9 (6)c	8 (5)c	23 (15)c	15 (10)c
Recovery w/o antibiotics is possible
Yes	269 (45)	61 (41)	70 (47)	64 (43)	74 (50)
No	162 (27)	32 (21)	32 (21)	54 (36)	44 (29)
“I don’t know”	169 (28)	57 (38)	48 (32)	32 (21)	32 (21)
Knowledge on antibiotic resistance
Yes	344 (57)	117 (78)b	89 (59)	58 (39)b	80 (53)
No	144 (24)	14 (9)	29 (19)	64 (43)	37 (25)
“I don’t know”	112 (19)	19 (13)	32 (22)	28 (18)	33 (22)
Parental concern on unsuccessful outcome w/o antibiotics
Yes	442 (74)	111 (74)	110 (73)	101 (67)	120 (80)
Not	158 (26)	39 (26)	40 (27)	49 (33)	30 (20)
Parental concern on unsuccessful outcome w/o antibiotics	n = 442	n = 111	n = 110	n = 101	n = 120
Pain and suffering	131 (30)	37 (33)	28 (25)	35 (35)	31 (26)
High fever	110 (25)	21 (19)	26 (24)	32 (32)	37 (31)
Other complications	201 (45)	53 (48)	56 (51)	34 (33)	52 (43)

¹“Only”;

^aP < 0.05 (χ²);

^cP < 0.05 (χ²);

^bP < 0.001 (χ²).

Table 3 Parental knowledge about the watchful waiting approach for acute otitis media therapy n (%)

Statement	Total	Center A	Center B	Center C	Center D
	n = 600	n = 150	n = 150	n = 150	n = 150
Physician recommendation in the past
Yes1	194 (40)	69 (61)b	41 (37)b	40 (32)b	44 (32)b
Not1	291 (60)	44 (39)	69 (63)	85 (68)	93 (68)
Not relevant	115 (19)	37 (25)	40 (27)	25 (17)	13 (9)
Acceptance of WW recommendation
Yes	337 (55)	79 (52)	70 (47)a	92 (61)	95 (63)a
Probably yes	178 (30)	45 (30)	51 (34)	46 (31)	36 (24)
No	5 (9)	22 (15)	17 (11)	5 (3)	7 (5)
“I don’t know”	33 (6)	4 (3)	12 (8)	7 (5)	12 (8)
Want to be included in physician decisions
Yes	552 (92)	135 (90)	129 (86)	143 (95)	145 (97)
Probably yes	36 (6)	11 (7)	17 (11)	6 (4)	2 (1)
No	5 (1)	3 (2)	0	0	2 (1)
“I don’t know”	7 (1)	1 (1)	4 (3)	1 (1)	1 (1)

¹From all parents with past experience with otitis media;

^aP < 0.05 (χ²);

^bP < 0.001 (χ²). WW: Watchful waiting.

Table 4 Logistic regression analysis: Parameters influencing the parental willingness to accept the watchful waiting approach

Parameters	P value	OR	(95%CI)
			Lower	Upper
Previous AOM history	0.012	0.341	0.148	0.778
Knowledge on antibiotic resistance	0.026	2.001	1.087	3.685
Parental education	0.028	1.461	0.789	2.706
Parental age	0.607	0.986	0.936	1.040

AOM: Acute otitis media.