Patient Preferences and Decision-Making

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 (Grtner et al., 2019). This has been the case for patients in Palliative Care setting 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.

References

Grtner, F. R., Portielje, J. E., Langendam, M., Hairwassers, D., Agoritsas, T., Gijsen, B., . . . Stiggelbout, A. M. (2019).

               Role of patient preferences in clinical practice guidelines: a multiple methods study using guidelines from oncology as a case.

               BMJ Open, 1-11.            

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Karlsen, M. M., Happ, M. B., Finset, A., Heggdal, K., & Heyna, L. G. (2020). Patient involvement in micro-decisions in intensive care. Patient                      Education and Counseling, 1-8.

 .waldenulibrary.org/science/article/pii/S073839912030207X?via%3Dihub.

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. 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. proquestcom.ezp.waldenulibrary.org/docview/1797885427?