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NURS 6052 Discussion: Discussion: Patient Preferences and Decision Making

Patient Preferences and Decision Making

The patient decision aid is a way of assisting individuals in coming up with informed selections concerning healthcare that put into consideration their individual preferences plus values. Decision aids are a portion of a collective decision-making procedure, inspiring vibrant engagement by ailing individuals in healthcare verdicts (Opperman et al., 2016). The patient decision aids are intended to complement, unlike swapping counseling from a healthcare specialist. This discussion addresses my personal experience with ailing individuals’ healthcare verdicts and treatment.

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The ailing individual ought to be encompassed in the treatment strategy, with reference to my personal experience as a healthcare specialist (Hoffman, Montori & Del Ma, 2014). As the ailing individual and his household ought to agree to the medication. You might then encompass them in the medication strategy minus any challenges.

When I encompass the ailing individual or their household in the medication strategy in my medical performance, I have comprehended that the ailing individual or their household turns out to be quite compliant throughout the therapy. This channels to the desired result. The deficiency of ailing individual participation in the medication strategy can have a number of undesired outcomes, varying from approval to treatment result (Schroy, Mylvaganam & Davidson, 2014). In nowadays world, ailing individuals arrive

NURS 6052 Discussion Discussion Patient Preferences and Decision Making ESSAYS

NURS 6052 Discussion Discussion Patient Preferences and Decision Making ESSAYS

at health facilities with predetermined mentalities gleaned from the online sphere or a number of other information sources. In their points of view, they have a slew of questions relating to the therapy technique. Therefore, it is desirable to disperse fears and encompass them in the medication strategy.

In conclusion, patient decision aids are proficient in turning out to be reinforcement tools to enhance collective decision making. More application studies are needed to changeover ailing individual decision-making into scientific practice allowing proof and ailing individuals’ choices to be part of their treatment.

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

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, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid facilitate shared decision-making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011. 00730.x

Discussion: Patient Preferences and Decision Making

Great post, I do agree with the importance of collective decision-making in treating ailing patients. And indicating that proactive strategies should be applied to leverage Evidence-Based Practice in facilitating a values-driven care plan

Decision aids should not replace traditional counseling practices in patient-practitioner interactions. Yor emphasizes the complementary nature of decision aids, resulting in a more engaged and involved patient. Nurses should think about involving their patients.

As a result, the medium selected will raise awareness of the treatments, benefits, and risks. Furthermore, the individualized decision aid should be introduced prior to the scheduled visit. For instance, a visual learner would receive an online video-based decision aid before meeting with the care team (Schroy et al., 2011). The measure provides sufficient time for exploring the terms, costs, and procedures in the treatment options presented.

The professionals should refrain from using terms such as “low risk” to prevent ambiguity in decision-making. Since the patients are likely to have pre-determined mentalities from information gathered from friends or online sources, an interactive decision should be applied to reinforce understanding of treatment procedures (“The SHARE Approach”, n.d). Thereafter, the teach-based assessment methodology is introduced to assess the client’s perceptions regarding the care plans discussed. The structured system minimizes the risks of misconceptions undermining the incorporation of patient preferences into patient-centered care.

Ultimately, the selection of an appropriate decision aid will have a significant impact on shared decision-making outcomes. Nevertheless, the decision aids should complement and not replace traditional counseling. Also, the ailing patients should receive the tool prior to the scheduled discussion to ensure that they familiarize themselves with key learnings and terminology. Consequently, they will apply active participation in discussions over the values-driven practice.

References

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2011). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making: Colorectal cancer screening decision aid. Health Expectations, 17.

The SHARE Approach—Essential steps of shared decision making: Expanded reference guide with sample conversation starters. (n.d). AHRQ. https://www.ahrq.gov/health-literacy/professional-training/shared-decision/tool/resource-2.html

Discussion Board Week 11

As I ponder upon this experience although it happened so many years ago, I still feel the pain in working with a patient with terminal cancer and his family.  As a nurse case manager, this was a true learning experience in working with shared decision making, grief, resiliency, and dying with honor. The name and certain changes have been made to respect the family and HIPPA.  I have always learned more from my patients than they have ever learned from me.  I will call this man Matthew and I became his case manager before he was terminal.  When the chemotherapy stopped working, he signed up for medication trials.  As the pain became unbearable even with medication his family wanted him to stop the Cancer Trials which did nothing but make him even sicker and his family wanted him to accept Palliative Care. Palliative Care would give Matthew greater aid to his pain management needs, and allow him a team of help, nurses, and a Palliative Care PA which would improve his quality of life and give some relief to his family/caregivers.  Matthew was brought into the shared decision-making process with me as his case manager and his oncologist.  Matthew refused Palliative care although everyone knew it would make him more comfortable, he was not ready to stop fighting for his life.  Another decision was brought to him, a workbook and in a frank conversation with Matthew, I explained that I know how important it is to him that he has control over certain aspects of his life and believe it would be important that he make these decisions while he can do so, and the workbook would help organize these very important decisions.  Doing this workbook with Matthew, he was able to make Do Not Resuscitate Decisions, and elect a Health Care Power of Attorney.  Choices about whether he wanted extra sedation when the time came, nutrition, and several other ends of life decisions.  Whether to choose to die at home or at the hospice was also discussed.  During this process, he was comforted to know that his family was well taken care of, and he had a better picture of what to expect during this time.  When the workbook was completed, I revisited Palliative Care feeling that the time was right for him, and he gratefully accepted it.  The Guide to Advanced Illness Planning was similar to the plan that was used by Matthew and me, this workbook gave control and dignity to someone at a time when he had felt that he no longer had any control or say left in his life (Ottawa Hospital Research Institute, 2019).

According to Kon et al. (2016), it is important that the provider takes the patient’s goals, values, and preferences into consideration otherwise the plan will look more like that of the clinician.  By Matthew being included in this Shared Decision Making and assisted through making choices in the Advanced Illness workbook, it gave him the confidence he needed to transition to Palliative Care. I would personally use the Guide to Advanced Illness Planning in my own personal life, as these are choices that should not fall to family members who are also dealing with the serious illness of a family member.  According to Lyon et al. (2021), randomized control trials showed Advanced Care Planning has a three-time more odds of allowing biological caregivers to feel that they are on the same page as the patient battling with terminal illness. According to Luna-Meza, et al. (2021) healthcare providers oftentimes avoid talking about end-of-life decision-making due to their own uncomfortableness with this topic, as well as difficulties in speaking with families about end-of-life topics.  Some choices may be made without the patient or family being considered such as life-saving measures, with prolonging of life due to providers’ own fears of legal ramifications (Luna-Meze, 2021).  Having frank clear conversations regarding end-of-life issues such as palliative care, hospice care, and DNR can allow for a better quality of care, and access to end-of-life care (Luna-Meza, et al. (2021).  Shared-Decision Making in all studies noted shows the importance of the patients’ participation in end-of-life decision-making.  This can give control to the patient and better support for the family, as well as access to end-of-life care.

References

Kon, A. A., Davidson, J., Morrison, W., Danis, M., & White, Douglas B, (2016). Shared decision-making in intensive care units: Executive summary of the american college of critical care medicine and american thoracic society policy statement. American Journal of Respiratory and Critical Care Medicine, 193(12), 1334-1336. https://www.proquest.com/scholarly-journals/shared-decision-making-intensive-care-units/docview/1797885427/se-2?accountid=14872

Luna-Meza, A., Godoy-Casasbuenas, N., Calvache, J. A., Díaz-Amado, E., Gempeler Rueda, F. E., Morales, O., Leal, F., Gómez-Restrepo, C., & de Vries, E. (2021). Decision making in the end-of-life care of patients who are terminally ill with cancer – a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers. BMC Palliative Care20(1), 1–10. https://doi.org/10.1186/s12904-021-00768-5

Lyon, M. E., Caceres, S., Scott, R. K., Benator, D., Briggs, L., Greenberg, I., D’Angelo, L. J., Cheng, Y. I., & Wang, J. (2021). Advance Care Planning—Complex and Working: Longitudinal Trajectory of Congruence in End-of-Life Treatment Preferences: An RCT. American Journal of Hospice & Palliative Medicine38(6), 634–643. https://doi.org/10.1177/1049909121991807

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