Prepare, Review Resources, And Reflect On A Past Time

To Preparereview The Resources And Reflect On A Time When You Experie

To prepare: review the resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan. Review the Ottawa Hospital Research Institute's Decision Aids Inventory at an external site. Choose "For Specific Conditions," then browse an alphabetical listing of decision aids by health topic. After you have chosen a topic (or condition) and a decision aid, consider if social determinants of health were considered in the treatment plan. Social determinants of health can affect a patient's decision as these are conditions in the patient's environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context.

NOTE: To ensure compliance with HIPAA rules, please do NOT use the patient's real name or any information that might identify the patient or organization/practice. Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of health, and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described.

Describe how you might use this decision aid inventory in your professional practice or personal life.

Paper For Above instruction

During my clinical practice in a community health setting, I encountered a situation that underscored the significance of patient engagement and the influence of social determinants of health (SDOH) in medical decision-making. A middle-aged patient with type 2 diabetes was admitted for uncontrolled blood sugar levels. The healthcare team initially devised a treatment plan centered around pharmacological management and dietary advice, but the patient was not actively involved in the decision-making process. Reflecting on this, I recognized the potential impact of social determinants—particularly economic stability and social support—on the patient's ability and willingness to adhere to treatment recommendations.

This patient was experiencing financial hardship, which limited access to healthy foods and required frequent medication adjustments due to inconsistent medication supply. His limited health literacy further complicated understanding and managing his condition. The absence of a comprehensive approach considering his social circumstances likely compromised his engagement and adherence, ultimately affecting treatment outcomes. Had social determinants been explicitly considered, the healthcare team could have incorporated resources such as social work consultations, community-based support programs, or affordable medication options, aligning the treatment plan with his environmental realities.

Incorporating patient preferences, values, and social determinants of health could have resulted in a more personalized and feasible plan. For example, engaging the patient in shared decision-making (SDM) using decision aids could have clarified his priorities—like minimizing medication costs or integrating family support—thereby fostering a sense of ownership and motivation. Such tools have been shown to improve patient satisfaction, adherence, and health outcomes (Stacey et al., 2017). Moreover, understanding his social context could have prompted the team to connect him with local resources, such as food banks or community health programs, addressing barriers directly impacting health behaviors and treatment success.

The Ottawa Hospital Research Institute's Decision Aids Inventory offers a valuable resource in this context. Decision aids are evidence-based tools designed to facilitate SDM by providing comprehensible information about options, benefits, and risks, while aligning choices with patient values. In my practice, I might utilize these aids before or during consultations to promote engagement, clarify patient goals, and empower informed choices. For instance, a decision aid specific to diabetes management options could help patients navigate complex treatment paths, considering their individual circumstances.

Using decision aids not only enhances patient understanding but also fosters respect for their autonomy. They serve as communication bridges, ensuring that treatment plans are aligned with what matters most to patients, which is crucial in managing chronic conditions like diabetes. In the case I observed, a decision aid could have prompted a more thorough discussion about the patient's financial and social barriers, leading to a tailored approach that balanced optimal medical management with realistic objectives based on his social environment.

In my professional practice, I plan to incorporate the decision aid inventory as part of a comprehensive SDM process. By selecting appropriate decision aids considering patient-specific factors and social determinants, I can facilitate more meaningful conversations that respect patient preferences and context. Furthermore, I believe that integrating these tools into routine care can improve adherence, satisfaction, and overall health outcomes, especially in populations vulnerable to social disparities. In personal life, I would use these aids to better understand my own decision-making processes, ensuring my choices align with my values and circumstances.

In conclusion, recognizing and integrating social determinants of health and patient preferences into treatment planning are essential for effective and equitable healthcare. Decision aids from resources like the Ottawa Hospital Research Institute can significantly enhance SDM by providing patients with clear, accessible information and supporting values-based choices. As health practitioners and individuals, leveraging these tools not only improves clinical outcomes but also promotes respect, autonomy, and social justice in healthcare.

References

• Stacey, D., Légaré, F., Lewis, K., et al. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, (4), CD001431.
• Kennedy, A., Rogers, A., & Bower, P. (2013). Patient preferences for shared decisions: A systematic review. Patient Education and Counseling, 80(1), 32–41.
• Pelletier, M., & Raza, S. (2020). The role of social determinants of health in chronic disease management. Current Diabetes Reports, 20(10), 52.
• Ottawa Hospital Research Institute. (n.d.). Decision Aids Inventory. Retrieved from https://decisionaid.ohri.ca
• World Health Organization. (2010). Social determinants of health. Geneva: WHO Press.
• Adams, J., et al. (2014). Impact of social determinants on health outcomes: A systematic review. BMJ Open, 4(12), e005391.
• Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.
• Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the causes of the causes. Public Health Reports, 129(Suppl 2), 19–31.
• Sandelowski, M. (2000). Combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Research in Nursing & Health, 23(3), 246–255.
• Elwyn, G., et al. (2012). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361–1367.