Patient Preferences And Decision Making In Patient-Centered
Patient Preferences And Decision Makingpatient Centered Care Is One Of
Patient-centered care is one of the most recent developments in nursing and clinical practice. Incorporating clients into clinical decision-making has been shown to improve recovery plans, cost-effective interventions, and the selection of the best therapeutic modalities. In the long run, all of these have enhanced patient care and results. Patients and their families may decide on preferred treatment approaches for nurse practitioners to follow to make them feel more comfortable, or because the patient or family has researched high success rates. In home-based care, where the client's family plays an important part in treatment and rehabilitation, patient preferences are critical.
However, it is important to highlight that collaborative decision-making has limitations. As a result, by reviewing a specific clinical practice experience where patient preferences and inclusive decision-making impacted the progression of the situation and the treatment plan, this discussion will explore the specifics of how patient preferences influence the outcomes of care from a nurse's perspective. The discussion also includes an explanation of how the chosen patient choice can benefit and aid future nursing professional practice. Several therapeutic interventions in healthcare have attempted to incorporate patient preferences and collaborative decision-making to improve patients' quality of life while undergoing treatments (Gärtner et al., 2019).
This has been the case for patients in palliative care settings receiving therapy and care. Patient preferences for cancer therapy and treatment alternatives, when to commence specific treatment protocols, whether to go for screening tests, and the sort of therapies to choose based on the patient's values, among other things, have all been accommodated. Prior to working at my current position, I had worked with a 48-year-old mother with two daughters ages 15 and 13 years old respectively, who had survived breast cancer for ten years. Her breast cancer had relapsed and impacted her lumbar spine, thus she had chronic back discomfort. Her oncologist recommended treatment with anticancer hormone drugs in combination with radiation therapy.
When it became evident that her disease would not be treatable in the long run, she was recommended for palliative treatment, which would help her manage her symptoms. She was subjected to several cancer therapies over three years, all of which proved futile in the end. The patient was compelled to choose between continuing her cancer treatments, undergoing further life-prolonging treatments such as cardiopulmonary resuscitation, and being admitted to the intensive care unit, among other options. I had the opportunity to use patient decision aids as one of her caregivers. Some of the decisions to be taken were micro-decisions which are sometimes fraught with difficulties due to communication gaps (Karlsen, 2020).
The patient had to choose between staying in the hospital and being treated in the privacy of her own home. When shared decision-making is not launched effectively, significant complications can occur, and patient care must be patient-centered (Kon et al., 2016). It was necessary to consider the patient's values. Thus, her caregivers, including me, unanimously supported her desire to receive home-based care so that she could spend quality time with her two girls.
She needed palliative care in the comfort of her own home so that when it was time for her to die, she could die peacefully while surrounded by her loved ones. The preferred aid I selected was intended to help the patient in part by focusing on her daughters. It entailed determining the breast cancer risks for her two kids, as requested by the patient. I suggested that they do a BRCA gene test to assess their hereditary propensity to breast cancer as well as other risk factors so that screening and treatment could begin sooner. The patient felt relieved and accepted her terminal situation after learning that her girls would be fine, and she didn't have any regrets about opting for home-based care.
Overall, patient preferences and participation in decision-making about their personalized care are crucial in achieving better results. When patients' wishes are in accordance with the treatment and care interventions they get, they respond well to treatment. Decision aids improve decision-making by demonstrating the advantages and disadvantages of each option and highlighting some inherent possibilities.
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In contemporary healthcare, patient preferences and shared decision-making have become cornerstones of patient-centered care, especially in nursing practice. Recognizing patients as active participants in their health management not only fosters respect for their values and desires but also leads to improved health outcomes, patient satisfaction, and adherence to treatment plans. This approach contrasts traditional paternalistic models where healthcare professionals unilaterally determined care protocols, often overlooking individual patient values and wishes.
The integration of patient preferences into clinical decision-making is particularly significant in complex and emotionally charged settings such as palliative care. Palliative care emphasizes symptom management, quality of life, and respect for patient autonomy, making patient preferences central to care planning. When patients face terminal illnesses, their choices about treatment options, including whether to pursue aggressive therapies or opt for comfort measures, profoundly impact their end-of-life experience (Gärtner et al., 2019). Understanding and respecting their individual values ensures that care aligns with what they consider meaningful, thus providing psychological comfort and dignity.
A notable example illustrating the importance of patient preferences involves a middle-aged woman with recurrent breast cancer. Her case underpins key aspects of shared decision-making, including evaluating treatment options in accordance with her values and family considerations. Her decision to transition from aggressive therapies to home-based palliative care exemplifies patient-centered decision-making. It underscores the balance clinicians must strike between medical recommendations and respecting patient autonomy. Utilizing decision aids facilitated her understanding of complicated choices, such as genetic testing for her daughters' hereditary risk, which provided her with peace of mind and a sense of control over her circumstances (Karlsen et al., 2020).
Effective communication is fundamental to shared decision-making. Nurses and other healthcare providers play vital roles in conveying complex information clearly, assessing patient values, and ensuring that patients understand their options. Miscommunication or insufficient involvement can lead to adverse outcomes, including decreased patient satisfaction and poor adherence to treatment plans (Kon et al., 2016). In the case example, collaborative decision-making led to a care plan that honored her wishes for home-based palliative care, ensuring psychological and emotional benefits for her and her family.
Despite its benefits, patient-centered decision-making presents challenges, including time constraints, differing perceptions of risk, and potential caregiver conflicts. Moreover, some patients may lack adequate health literacy, making it difficult to fully comprehend options and implications. Therefore, clinicians must employ tools such as decision aids, visual aids, and tailored education strategies to facilitate understanding and support truly informed choices (Gärtner et al., 2019).
In addition to benefiting individual patients, incorporating patient preferences enhances overall healthcare quality and sustainability. Engaged patients are more likely to adhere to treatment regimens, avoid unnecessary interventions, and experience higher satisfaction levels. This approach also aligns with ethical principles of respect for autonomy and beneficence, fostering trust between patients and providers (Gärtner et al., 2019).
In future nursing practice, emphasizing shared decision-making can promote a more holistic, respectful, and effective healthcare environment. Training nurses and healthcare workers in communication skills and cultural competence is essential to ensure they can support diverse patient populations in making informed choices. Additionally, integrating decision aids into routine care can streamline the process, making it more accessible and effective. Recognizing and valifying patient preferences ultimately leads to more personalized and compassionate care, improving health outcomes and patient well-being.
In conclusion, patient preferences and shared decision-making are fundamental to delivering quality, patient-centered care. They empower individuals to participate actively in their health choices, fostering dignity, satisfaction, and better health outcomes. As exemplified by the case of the woman with recurrent breast cancer, tailoring care plans in accordance with patients’ values can significantly enhance their quality of life, especially in palliative settings. Future nursing practice must continue to prioritize these principles by fostering effective communication, utilizing decision aids, and addressing barriers to patient participation.
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