NURS 6521 Week 11 Sample Discussion

Patient Preferences and Decision Making

Diseases and treatments can become compound, thus involving patients in the decision-making process is essential. Patient participation or involvement in the care process entails shared decision-making or allowing patients to share their views concerning distinct treatment procedures. Factors impacting patient involvement include reasons connected to health care experts like clinician-clientele interaction, allocation of adequate time for involvement, and acknowledgment of patient’s knowledge. Other factors are client-related and include patient’s cognitive and physical capacity, values, beliefs, knowledge, and emotional connections. Essentially, patient participation empowers patients, enhances health results and services, and ensures jointly agreeable medical decisions.

My experience involved providing patient J. R. with CRC (colorectal cancer) screening decision aids, to categorize a chosen screening alternative. Involving J. R in the decision-making process when faced with delicate selections in relation to cancer treatment and screening was vital to the conception of patient-based care. The process took place within the setting of SDM (shared decision making), where J. R and a team of care providers formed a partnership to simplify principles and morals, discuss statistics, and convey a jointly agreeable medical decision.

Essentially, collaborative decision-making tends to empower patients to make a knowledgeable, value-based decision concerning a particular course of action of care. Such empowerment enhances the patient’s comprehension of probable risks, benefits, scientific uncertainty, and probabilities. Decision aids also enhance the efficiency and quality of the patient-clinician encounter and enable patients to engage in decision-making (Melnyk & Fineout-Overholt, 2011). Research has proved that decision aids boost familiarity and information, alleviate decisional conflict, facilitate informed value-founded verdicts, and raises participation in the decision-making procedure (The Ottawa Hospital Research Institute, 2019). However, their influence on the decision quality, health outcomes, and satisfaction with the procedure of making decisions is still uncertain.

The decision aid tool employed art graphics and pictures, and videotaped narratives in DVD data format to communicate crucial statistics concerning colorectal cancer and the significance of screening. The graphics and narratives also compared the five suggested screening alternatives utilizing both option-based and attribute-based methodologies, and prompt patient partialities. The implement also integrated the CRC risk assessment tool. Patient J. R. engaged in an interactional computer forum before a planned session with the practitioner.

The decision aids tool allowed J. R. to classify a chosen screening selection founded on the comparative ideals based on distinct test features. The tool also increased J.R.’s understanding and familiarity with CRC screening. Unlike other patients who did not engage in patient participation, J. R.’s fulfillment with the decision-making procedure and screening purposes was augmented. However, in a case where the provider’s and patient’s preferences vary, test ordering and screening intentions are negatively impacted (Schroy, et al, 2014). Fortunately, J. R.’s and the provider’s test ordering and screening intentions were similar, providing patient satisfaction and the best outcomes.

Patient involvement in the decision-making process is a suitable use of the client’s clinic time, saves clinicians time, and amplifies patient familiarity with the numerous screening selections, encompassing their risks and benefits. As a result, the process allowed J. R. to categorize a preferred screening option and augmented his wish to get screened.

Notably, the clinician’s impartial and unbiased participation in the valuation of the usefulness of the tool enabled the clinicians to adapt their consultative method to J. R.’s requirements, enhancing the quality of J. R.’s visit, and increasing his satisfaction with care. Significantly, health providers must measure the educational intervention’s impact to validate the achievement of professional development activities (Opperman et al., 2016). A major aspect to consider is the financial impact measurement, including the benefit-cost ratio and cost analysis. It is essential for providers to proactively validate the educational programs and the value of the decision aids tools.

Most critical care professional institutions authorize SDM (shared decision making) as a fundamental element of patient-based care. According to Kon et al. (2016), providers should integrate the decision-making approach in assessing and managing patient’s needs and preferences. Notably, few ethical validations exist for formulating collaborations and partnerships between patients and practitioners. Practitioners have a legitimate function in the procedure of making decisions due to their proficiency in medicine and understanding of the medically specified interventions.

Allowing patients to participate in the procedure demonstrates respect for individuals, a principal ethical duty of the medical profession. Additionally, patient involvement guarantees that the decisions made are in line with the goals, preferences, and values. Hoffman, Montori, & Del Mar assert that shared decision-making and evidence-based medicine are fundamental to quality care, yet the interdependence between the two methods is not commonly appreciated (2014).

The SDM intends to guarantee treatment options and decisions that are medically suitable and compatible with the client’s goals, ideals, and likings. Occasionally, though, such partnerships fail to produce satisfactory decisions for the patient or the clinical team. When such cases arise, it is obliging to conscript the support and aid of clinical ethics counselors at conflict resolution (Kon et al., 2016). Ethical validations promote the decisions made from such partnerships.

As discussed in this paper, patient participation in healthcare decision-making is significant as it empowers and boosts health and services outcomes for the patient. To promote professional practice, it is essential to integrate patient knowledge and viewpoints, alongside the clinician’s scientific and professional clinical knowledge in the care of patients. Specifically, such approach to patient care seeks to address any existing doubts in the minds of patients, in addition to giving them the opportunity to not only share their views, but also actively make decisions based on their treatment preferences.

References

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: an American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Opperman, C., Liebig, D., Bowling, J., Johnson, C. S., & Harper, M. (2016). Measuring Return on Investment for Professional Development Activities:: Implications for Practice. Journal For Nurses In Professional Development, 32(4), 176-184. doi:10.1097/NND.0000000000000483
Schroy III, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27-35. doi:10.1111/j.1369-7625.2011.00730.x
The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/