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NURS-6052N Week 11 Discussion (Marla)
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NURS-6052N Week 11 Discussion (Marla)
Patient participation in healthcare decision-making includes comprehensive
discussions and considerations of their unique needs and preferences. It is often the case
argued that patient participation results in improved medical outcomes, including patient
safety. However, patients and their preferences remain largely misunderstood or less
understood. Patient participation will illuminate on patient preferences, which are
deliberations about the unique aspects of anticipated treatment. The preferences will refer to
the patient’s assessments of the proposed intervention and outcomes as per their underlying
beliefs, values, perceptions, and information. Therefore, patient preferences result from
experiences, reflection, and cognition (Ringdal et al., 2018). In my career, I have come to
understand that patient participation through the inclusion of preferences can improve and
pose risks to medical outcomes. If healthcare practitioners had a firmer understanding of
patients’ health-related preferences, then the provision of care would be cheaper, more
effective, localized, and closer to the patient’s individual desires.
I recall working with a 69-year old Indigenous American from Oklahoma who had
just received a positive diagnosis for throat cancer. As a man who had grown up much of his
life in reserve communities, the patient did not have access to medical insurance. In fact, the
patient did not see the importance of having insurance, citing it as a capitalistic approach to
healthcare service delivery. The patient also did not see the value of undergoing modern
management procedures, such as radiotherapy. Not only did the medical procedure cost too
much for him, it did not have any spiritual aspect to it, making it seem inappropriate. The
patient advocated for the use of interventions rooted on the earth, such as herbal medicine,
which he perceived would be more effective that modern pharmacological approaches.
Convincing the patient to abandon this archaic view of medicine was the primary challenge in
this patient interaction.
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Spirituality and religious beliefs have been found to be important for patients
suffering from major illnesses. I observed the major clinicians do their best to integrate
spiritual and religious coping to enable the patient to adjust to their medical condition. For
example, the patient’s room was filled with various cultural artefacts, which I learned had
spiritual purposes. However, I also identified the use of patient decision aids to also help the
patients better adjust to their medical condition. The decision aids were not used to replace
medical consultations but to support interactions between the patient and clinician (Stacey et
al., 2018). Pamphlets on the proposed medical interventions and personal videos giving
testimony on patient experiences with the interventions were used. The subsequent
discussions with the patient led to the collection of information applied to identify or design
the most suitable treatment approaches for the patient (Hoffman et al., 2014). The goal was
the patient not to have any unfulfilled personal and spiritual needs throughout the cancer
management and treatment process.
I intend to continue using decision aids to help patients make better informed choices
about the care they receive. My understanding of the tools is that they convey a deeper
respect for the patient, including their autonomy and consent. While decision aids have the
ability to enhance the quality of care, their effective use is dependent on the attitudes and
competencies of the healthcare professionals engaging with the patients. Therefore, it is for
the nurse and the clinician to ensure the patient is aware of the importance of using such aids.
I would feel more confident in my care delivery if I understood its design and development
stemmed from collaborative consultations with patients and close family members. All
relevant parties should be given the opportunity to actively participate in decision-making on
complex medical decisions.
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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
Ringdal, M., Chaboyer, W., Ulin, K., Bucknall, T. & Oxelmark, L. (2018). Patient
preferences for participation in patient care and safety activities in hospitals. BMC
Nursing, 16(69), 1-8.
Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., Holmes-Rovner,
M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., & Trevena, L. (2017).
Decision aids for people facing health treatment or screening decisions. The
Cochrane Database of Systematic Reviews, 4(4), CD001431.
https://doi.org/10.1002/14651858.CD001431.pub5
