discussion 100

Patient Preferences and Decision Making

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare

By Day 6 of Week 11

Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.

RESPOND TO THE TWO DIFFERENT COLLEAGUE AND EACH RESPONSE ADD 2 APA CITATIONS AND REFERENCES.

COLLEAGUE1

Hello Colleagues,

In the discussion forum this week, we are describing experiences with patient treatment and patient involvement with health care decisions. The discussion this week will allow for me to expand on the impact on outcomes for incorporating the patient’s values in their treatment plan. There will also be a conversation of patient values and preferences can impact and reflect the treatment plan. To conclude the discussion I will review the value of a patient’s preferences to influence an effective treatment plan in not only my experience but also in general terms. Reflecting on an experience such as this one will allow for me to explore opportunities for scenarios in the future and its effect on my professional practice.

Experience Reflection and Patient Impact on Treatment

In my experience as a nurse in the hospital, I have seen many patients who receive the care they need to get well. One experience in particular which relates to this week’s discussion is when I took care of an older adult male patient with intermittent periods of dementia who had been on dialysis for quite some time and was debating on stopping dialysis treatment. He stated that dialysis was not something he wanted to do anymore because it took a long time, made him feel tired, and overall decreased his quality of life. The patient stated that he was tired of doing dialysis after doing it for so many years and he would like to be on hospice.

Allowing the patient to voice his feelings, preferences, and decision allowed for him to address his options with the health care team and his family. Including the patient and his family in the risk of not receiving dialysis and how it would allow him to pass away naturally was also important. The patient did want the family to be present and by doing so it provided the family to also address any concerns that the patient may have forgotten. The experience did allow for the patient to address his concerns in that moment and the feelings of wanting to stop dialysis treatment. According to Kuosmanen et. al., (2021), patient expectations for their plan of care need to be frequently assessed and corrected if necessary. Patients may feel like they need to make a decision on their care one day and then the next day they do not want to go forward with that plan of care and may change their mind. In this experience, the patient did state he wanted to be done with dialysis however, after discussing with his family, he decided to go to dialysis.

According to Melnyk and Fineout-Overholt (2018), patient centered care allows for health care professionals to iinte3ract with patients and increase knowledge and understanding to determine their own values and preferences. The impact of patient preferences of values on the treatment plan for the patient in my experience did increase myself and health care professionals to come together and support the patient’s decision in his plan of care and creating the foundation to a discussion that would eventually populate again in the future (Melnyk & Fineout-Overholt, 2018).

Patient DecisionAide Creating Effective Decision Making

The decision aid which I have chosen to use in this experience is called, “Advance Care Planning: Should I Stop Kidney Dialysis?” (Healthwise.net, 2021). The decision aide would assist with allowing the patient to address any concerns he had and to have a printed out document which answered his questions about concluding dialysis and what to anticipate to a degree. According to Kuosmanen et. al., (2021), patient views on quality of life need to be the basis for the decision-making process. Frequently assess patients’ preferences and values are essential because patients may change their mind with no warning. Through proper assessment of patient values and preferences overtime the patient will begin to build a report with the healthcare team to strengthen their decision-making process as they become more familiar with the care they desire.

Conclusion

In the discussion this week I addressed an experience that I had involving patient participation with treatment plan of care. Understanding the patient’s values and preferences in their care is necessary as it is ultimately their decision in the treatment they receive. Providing the patient appropriate education and evidence to support the plan of care options will allow for positive outcomes. Effective decision making can be achieved through the use of decision aides, which provide information on different health care topics and allow for greater understanding of the options, outcomes, and preferences to be addressed. As a soon to be practitioner, it is crucial to understand the impact of patient participation in care design and treatment plan.

COLLEAGUE 2

Discussion: Patient Preferences and Decision Making

Involving patients in making some decisions is common because of the elevation of technological practices and knowledge. I remember an experience with a patient who had Alzheimer's disease symptoms but was reluctant to get the necessary medication. The condition is mental and involves a series of therapies. However, the patient found difficulty, claiming the condition was not very impactful. The patient was male and suffered from several instances of memory loss. The patient confessed to having difficulty in seeking medical attention and was assisted by other family members. The situation was complicated because the patient saw very little effects from the challenge he was having. In treatment, the patient developed several issues because of the lack of support for the treatment process. The condition has no known cure but can be treated through cognitive-enhancing therapies. The patient was aware of the lack of treatment immediately after diagnosis, and it became difficult to convince him of the therapies required. He claimed to have a busy schedule and that he would dedicate much time to the treatment. I created a flexible treatment plan with many recommendations that were not considered. The patient did not consider the treatment options because of the flexible plan. I found out that after a while, the condition worsened because more brain cells died. I confirmed with the patient, and I realized that the recommendations were not met. From experience, I realized something about patient aided decision-making.

Patients can impact the kind of treatment offered to them in several ways because of the flexibility of some parameters. The treatment plan I developed for the particular patient was flexible because of the platform for treatment discussions that I presented. The treatment decision aid was relevant because the particular condition has registered no major treatment platform. Treatment for such disorders and diseases creates a treatment discussion platform where knowledge can be shared and developed effectively (Hoffmann, 2014). Regrettably, the particular treatment discussion did not work because of several issues already indicated. The perception that is developed by patients when presented with an opportunity to make decisions becomes predictable. Technology has developed and offered channels for developing and promoting knowledge. However, the kind of information and the type of decisions require a lot of discussion before developing treatment plans. The patient preferences and values are essential in situations where treatment is unknown, but recommendations are possible. Patients with background information can be handled differently because the treatment plans developed after analysis and discussions appear different. The process can be attributed to the platforms developed with many options (Koo et al., 2017). The care offered and the treatment process becomes different due to variation in thoughts ad practices. However, a better platform can be presented when there is an agreement on the set recommendations and ideas.

Treatment is a critical dimension in the health practice dimension because it creates a chance to handle and manage the presented conditions. The process is delicate because further visits to the healthcare facility can be reduced. Involving patient values and preferences can influence the development of a treatment plan. As earlier indicated, technological advancement and more educational platforms have created a platform where most information can be generated and shared in various dimensions. The opportunities and preferences result in a flexible treatment plan because patients have developed knowledge that can be directly applicable to the situation (The Ottawa Hospital, 2010). The discussions can be attributed to the kind of situations presented after the treatment process. An advanced form of knowledge can be developed from the discussion, resulting in a positive impact. Also, based on what the patient can afford, for some instances, the knowledge from the patient is necessary because of the opportunities presented. The general result should be the treatment, and every process that works towards it can become an option (Ringdal et al., 2017). The kind of knowledge presented by the patients in terms of their conditions and what they can contribute to the treatment process should be considered. The considerations directly impact the treatment plan, and if care is not taken, either from the patient or the practitioner, the treatment plan may be less effective. The intended purpose may not be met completely based on the results after deliberating on some ideas.

Treatment patient decision aid is essential because it contributes to the intended purpose of the visits to the health centers. Treatment can contribute to an effective decision-making process through the discussion platform presented. In most cases, the physician knows best due to their knowledge and experience. However, because patients are the implementers of the treatment plan, it becomes more effective when actively involved. The process has the danger of creating flexible recommendations, as recorded in the experience. In general, however, the danger is not experienced unless troublesome patients because of the treatment desire. In instances where the treatment process may not be directly known, decision-making becomes very effective because of the discussion that can be created and achieved. The process becomes completely successful as a result of the support from the patient. Failure of the patient involvement results in a condition where the patient is exposed to a series of recommendations that may not be supported (Schoenfeld et al., 2018). I can use the decision aid inventory to ensure that every process is outlined effectively, ensuring every created decision is in line with the expectations. The relevant decision aid is provided for every treatment condition, creating accuracy and affirmation necessary in my professional practice and personal life. Through exposure to better platforms, I develop the opportunity to practice the profession more appropriately and in a wider dimension. It is possible to have better skills and experiences through the exposure to more relevant platforms.