How can patient participation go beyond autonomy and informed consent

Full Answer Section

     

• Evidence retrieval and evaluation: The ability to find, assess, and interpret relevant research evidence.
• Decision analysis: The ability to help patients weigh the benefits and risks of different treatment options.

Elements Enabling Patient Participation in Medical Decision-Making Box 12.2 outlines the elements that enable patient participation in SDM:

• Information: Patients need to receive clear and understandable information about their condition, treatment options, and potential outcomes.
• Choice: Patients should be offered a choice of treatment options that are consistent with their values and preferences.
• Support: Patients should receive support from healthcare providers to make informed decisions.

Shared Decision-Making Beyond Autonomy and Informed Consent While autonomy and informed consent are essential components of SDM, patient participation can go beyond these concepts. In a true SDM process, patients should be actively involved in all aspects of their care, including:

• Goal setting: Patients should be involved in setting their own healthcare goals and priorities.
• Risk assessment: Patients should be helped to understand the risks and benefits of different treatment options.
• Decision-making: Patients should be empowered to make their own decisions about their care, with support from healthcare providers.

Facilitating a Conversation with Patients and Families As a nurse, I would facilitate a conversation with patients and families regarding medical care decisions by:

• Building rapport: Establishing a trusting relationship with the patient and family is essential for effective communication.
• Providing clear and understandable information: Using plain language and avoiding medical jargon.
• Encouraging questions: Creating a safe and open environment for patients and families to ask questions and express their concerns.
• Respecting patient autonomy: Allowing patients to make their own decisions, even if they differ from my recommendations.
• Using decision aids: Providing patients with decision aids that can help them weigh the benefits and risks of different treatment options.

Addressing Differing Preferences and Evidence-Based Recommendations If a patient's preference differs from the evidence-based recommended intervention, I would:

• Explore the patient's reasons for their preference. Understanding their underlying values and concerns can help me to tailor my approach.
• Provide additional information. I may need to provide more information about the evidence-based recommendation to address the patient's concerns.
• Discuss potential compromises. In some cases, it may be possible to find a compromise that balances the patient's preferences with the evidence-based recommendations.
• Respect the patient's decision. Ultimately, the patient has the right to make their own decisions about their care, even if they differ from my recommendations.

By following these principles, nurses can help to ensure that patients are actively involved in their care decisions and that their values and preferences are fully considered in the development of their treatment plans.  

Sample Solution

     

Evidence-based practice (EBP) involves the integration of the best available research evidence, clinical expertise, and patient values and preferences to guide healthcare decisions. Shared decision-making (SDM) is a key component of EBP, as it empowers patients to actively participate in their care decisions.   

Skills Required for Evidence-Based Shared Decision-Making

According to Box 12.1, the skills required for SDM include:

• Communication skills: The ability to effectively communicate with patients, including active listening, empathy, and clear explanation of complex information.
• Clinical expertise: A deep understanding of the medical condition, treatment options, and potential outcomes.