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Discussion: Patient Preferences and Decision Making

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Discussion: Patient Preferences and Decision Making

The engagement of patients in healthcare is not a new occurrence, although it was not initially a component of the healthcare system as also indicated by Sherman (2014).  Currently, patients want to have an input in the clinical procedures used in managing their conditions and they also want to highlight the endpoints that are best suited for their health care needs (Levitan, 2017). It means that further research on patient preference must be conducted to determine how and when to incorporate patient preferences when making health decisions in managing patient conditions. Altarum (2019) indicates that the incorporation of patient preference in healthcare goes beyond the conventional informed consent and is now an interdependent, interpersonal undertaking that comprises patient-provider collaboration in making patient care decisions. The effect of such collaboration reflects the expertise of the providers as well as the distinguished preferences of the patient, hence leading to better health outcomes and reduced costs of care. Such outcomes include reduced medical errors as well as improved patient safety.

The critical aspects needed in ensuring the effective incorporation of patient values and preferences include the recognition and acknowledgement by both the provider and patient of the need to make the decision as well as understanding the benefits and dangers of each option. It also entails ensuring that the decisions made incorporate the guidance of the providers and the preferences and values of the patient. One highly desirable outcome that this practice has brought in medical health is the inspiration of the development of enhanced strategies that educe and assess preferences in varied patient populations, a point advanced by Bywall, Veldwijk, Hansson & Kihlbom (2018)..

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Having served as a manager in an emergency room, I have experienced the privilege of assisting different types of patients with varied healthcare needs. I have served in assisted living establishments and even in home health care when the physician deemed it necessary. A particular experience that is still vivid in my mind is one that involved an elderly patient who was in need of home health care attention. The patient’s health care needs were being provided by her two sons, and their deep involvement in her care drowned the space for her to express her desires in the management of her condition. She desired to be admitted in an assisted living centre so that she could take part in occupational and physical therapy, which would have helped her regain the strength she had lost especially in the lower extremities.  She believed that she would have been much better especially in caring for herself if she could access that kind of assistance.

Due to the involvement of her sons, she could not confer with them on hr need to go to an assisted facility as it would help her recover much faster. The sons perceived that they could provide her with the care she needed at home and insisted on the providers of the care she needed to come to their home. In my view, had a nurse been involved in the consultations and especially in assessing the patient’s preferences and determining how her wishes could be granted, the sons would have seen the need for taking their mother to an assisted care centre. As a result of lacking the requisite understanding in accommodating patient preferences, the sons failed to consider the provisions advanced by the Ottawa Patient Aid regarding the considerations needed when requiring extra assistance at a facility or at home. As noted by O’Connor & Stacey (2010), the considerations include the determining whether the advanced illness is curable and if there is a wholesome plan to guide the admission of extra care when required.

With my advanced decisional aid, the elderly patient and her sons would have been informed better on the alternative that best suited her, and accommodating those important considerations would have guided their decision more appropriately. Conclusively, this decision aid inventory will help my professional practice because it will help me understand the biases I might have as a care provider, which, as also noted by Heath (2016), will help me understand my patients’ preferences. I now understand the importance of adopting the patient-centered strategy in healthcare delivery and embracing the fact that patients are sufficiently competent to make informed decision on how they would prefer being cared for. I also understand the need to support patients in dealing with the hindrances they might encounter in the process of articulating their preferences to the healthcare provider.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Altarum. (2019). The consumer benefits of patient shared decision making. Research brief, No. 37. Retrieved on 12th March, 2020 from healthcarevaluehub.org/advocate-resources/publications/consumer-benefits-patient-shared-decision-making

Bywall, K.S., Veldwijk, J., Hansson, M.G. and Kihlbom, U. (2018). Patient Perspectives on the Value of Patient Preference Information in Regulatory Decision Making: A Qualitative Study in Swedish Patients with Rheumatoid Arthritis. The Patient – Patient-Centered Outcomes Research volume 12, pages 297–305 (2019). Retrieved on 12th March, 2020 from https://link.springer.com/article/10.1007/s40271-018-0344-2

Heath, S. (2016). How to include patient preferences in shared decision-making. Retrieved on 12th March, 2020 from https://patientengagementhit.com/news/how-to-include-patient-preferences-in-shared-decision-making

Levitan, B. (2017). Patient preferences in healthcare decision-making. Retrieved on 12th March, 2020 from https://imi-prefer.eu/news/news-item/?tarContentId=642846

Sherman, R.O. (2014).  The patient engagement imperative. Retrieved on 12th March, 2020 from https://www.myamericannurse.com/the-patient-engagement-imperative/

O’Connor, A and Stacey, D.  (2010). When you need extra care, should you receive it at home or in a facility? A decision aid to prepare you to discuss the options. Retrieved on 12th March, 2020 from https://decisionaid.ohri.ca/docs/das/Plac

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