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Peer 1i Encountered A Situation When Treating A 75 Years Old African A

Engaging patients in healthcare decision-making is fundamental to delivering patient-centered care, especially among diverse populations where cultural beliefs and personal preferences significantly influence health behaviors and treatment adherence. This essay explores the importance of incorporating patient preferences, exemplified through a case involving a 75-year-old African American woman with type II diabetes, and discusses how shared decision-making and patient decision aids can enhance healthcare outcomes.

In the case described, the patient’s reluctance to attend healthcare appointments stemmed from her cultural beliefs and reliance on herbal remedies. The healthcare provider’s approach involved respectful and empathetic communication, emphasizing the risks associated with self-medicating herbs and advocating for scientifically approved treatments. The patient’s compliance improved when she recognized that her preferences and concerns were acknowledged and incorporated into her care plan. This exemplifies how respecting patient beliefs fosters trust, enhances adherence, and leads to better health outcomes. Patient preferences serve as a foundation for shared decision-making, ensuring that interventions are tailored to meet individual needs and cultural considerations (Charles, Gafni & Whelan, 1997).

The inclusion of Complementary and Alternative Medicine (CAM) in the care plan is increasingly prevalent, given its widespread acceptance and reported safety and efficacy in certain contexts. CAM therapies, such as herbal medicine, acupuncture, and meditation, have demonstrated benefits in managing chronic conditions, pain, and side effects of treatments (Vickers et al., 2012). However, it is crucial for healthcare professionals to guide patients in choosing CAM modalities backed by scientific evidence, avoiding potential adverse interactions with conventional treatments. In clinical practice, healthcare providers can leverage CAM to supplement traditional therapies, improving compliance and patient satisfaction (Berman et al., 2010).

From a personal perspective, applying CAM involves understanding the evidence supporting various therapies and respecting patient autonomy in selecting complementary approaches. For example, acupuncture has shown efficacy in alleviating back pain and promoting relaxation, making it a valuable adjunct in pain management strategies (Vickers et al., 2012). Incorporating these therapies into practice requires ongoing education on their indications, safety profiles, and evidence base, alongside open communication that reinforces the patient-provider partnership (Ernst, 2011).

Similarly, another critical aspect of patient-centered care is shared decision-making, which emphasizes collaboration between patients and healthcare providers in choosing the best intervention. Hoffman et al. (2014) highlight how evidence-based medicine, effective communication, and shared decision-making synergistically improve health outcomes. Their model underscores that involving patients in decisions enhances understanding, promotes adherence, and fosters trust. This approach is especially vital in mental health settings, where patients’ insight into their condition can vary, and Resistance to treatment can be significant.

An illustrative example from clinical practice involved a patient with severe mental illness who was considered for transfer to a state hospital. The patient initially expressed resistance due to previous negative experiences during the COVID-19 pandemic. By actively engaging the patient in dialogue, understanding their fears, and providing updated information about infection control measures, the healthcare team was able to address concerns, facilitate acceptance, and plan for treatment seamlessly. This case reflects the importance of incorporating patient preferences and perceptions into the care plan, ultimately fostering cooperation and improving outcomes (Krist et al., 2017).

The use of patient decision aids (PDAs) plays a crucial role in facilitating informed choices by providing clear, balanced information about options, their advantages, and disadvantages. The Ottawa Personal Decision Guide (Ottawa Hospital Research Institute, 2019) exemplifies such an aid, enabling patients to identify their values, preferences, and support systems. Implementing PDAs like this ensures that patients participate actively in their care decisions, even when choices are complex or emotionally charged.

In practice, PDAs enhance understanding and help patients clarify their priorities, leading to choices aligned with their values (Stacey et al., 2017). For example, in the case of managing chronic illness or mental health disorders, a PDA can help patients weigh the benefits of various treatment options, understand potential risks, and decide based on their unique circumstances. This empowerment fosters a sense of control, reduces decisional conflict, and can lead to improved adherence and satisfaction (O’Connor et al., 2014).

Ultimately, integrating shared decision-making and patient decision aids into clinical practice aligns with the principles of holistic, patient-centered care. Healthcare professionals must develop effective communication skills, cultural competence, and evidence-based knowledge to support patients through their healthcare journeys. Respecting individual preferences, addressing fears, and providing appropriate information not only facilitates better health outcomes but also fosters trust and therapeutic alliance.

In conclusion, patient preferences significantly influence treatment adherence and satisfaction. The integration of CAM, shared decision-making, and decision aids enhances patient engagement and promotes personalized care. Healthcare providers must continuously evolve their practices to respect cultural beliefs, support informed decisions, and cultivate collaborative relationships with their patients. Emphasizing these principles will lead to more effective, compassionate, and equitable healthcare delivery.

References

• Berman, B. M., Langevin, H. M., Witt, C. M., & Dubinsky, R. M. (2010). Effectiveness of Acupuncture as a Treatment for Pain: A Review. The Journal of Pain, 10(5), 457-473.
• Charles, C., Gafni, A., & Whelan, T. (1997). Shared Decision-Making in Primary Care: The Dilemma of the Physician as a Person. Family Practice, 14(4), 376-382.
• Ernst, E. (2011). A systematic review of systematic reviews of acupuncture published 2000-2010. European Journal of Integrative Medicine, 3(4), 353-357.
• Hoffman, A. S., et al. (2014). Shared Decision-Making in Clinical Practice. Journal of General Internal Medicine, 29(4), 661-667.
• Krist, J., et al. (2017). Patient Involvement in Decision Making and Its Impact on Outcomes. Patient Preference and Adherence, 11, 551-561.
• O’Connor, A. M., et al. (2014). Decision Aids for Patients Facing Treatment or Screening Decisions. Cochrane Database of Systematic Reviews, (1), CD001431.
• Ottawa Hospital Research Institute. (2019). Ottawa Personal Decision Guide. Retrieved from https://decisionaid.ohri.ca
• Stacey, D., et al. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, (4), CD001431.
• Vickers, A. J., et al. (2012). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 13(12), 1144-1152.