NURS 6052 Module 6 Week 11 Discussion: Patient Preferences and Decision Making
NURS 6052 Module 6 Week 11 Discussion: Patient Preferences and Decision Making
What has your experience been with patient involvement in treatment or healthcare decisions?
Mary Gomez (40 years and Hispanic) was a patient with incurable advanced breast cancer whom I interacted with during my internship placement at the New Presbyterian hospital in New York. Working with the cancer patient provided me with unique experiences regarding some of the key elements affecting patient involvement in treatment and decision making for advanced breast cancer. Notwithstanding the need for alleviation of suffering and improvement of quality of life, the patient experienced difficult decisions and ambiguous options regarding whether to be integrated into palliative care, forgo tumour-therapy or be involved in early-phase clinical research.
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In terms of my experiences with the patient, I truly admit that caring for a patient with advanced breast cancer and witnessing her suffering was practically challenging. For instance, the patient appeared to lack proper awareness about how to acquire professional assistance and this contributed to her reluctance to express her distinct needs and demands. Another specific example that affected the incorporation of patient preference was the patient lack of appropriate knowledge regarding breast cancer. For instance, despite experiencing the main signs and symptoms, she was fully unable to recognise it as what she witnessed at the time did not correspond with what she perceived breast cancer was.
In this scenario, identifying and integrating the preferences and needs of the patient into the last phase of life became a fundamental way for delivering high quality, holistic and patient-centred care and support (Laryionava & Winkler, 2019). Souliotis et al (2018) insisted that the continuous involvement of patient in Advance Care Planning may provide a useful starting point for the patient to actively engage in setting the goals of care, choosing treatment options and making future decisions that could influence the trajectory of the patient’s disease. In non-curative oncology, the involvement of the patient in the cancer treatment and healthcare decision-making played a role in facilitating the placement of the patient in hospice care as opposed to being referred to an intensive care Unit (ICU).
From a medical ethics viewpoint, proper assessment and integration of patient’s preferences, values and demands for participation in decisions and for information about treatment proved essential in enhancing the integrity of the patient’s decision-making capability, facilitating autonomy and boosting the patient’s right to self-determination (Vahdat et al., 2014). In non-curable cancer disease, a mammogram decision aid for women aged 40 to 49 years may prove useful to inform best practices for improved patient care and better healthcare decision-making. This decision aid tool may enable the patient and the medical personnel to conduct a risk assessment of the patient, engage in continuous screening and to compare treatment options including mastectomy, breast-conserving surgery and/or radiation treatments (The Ottawa Hospital, 2020).
References
Laryionava, K., & Winkler, E.C. (2019).Patients’ Preferences in Non-Curable Cancer Disease.Oncol Res Treat, 42:31-34. https://doi.org/10.1159/000496120
Souliotis K, Peppou L, & Tzavara C, et al (2018).Cancer patients’ organisation participation in heath policy decision-making: a snapshot/cluster analysis of the EU-28 countries. BMJ Open 2018;8:e018896. doi: www.10.1136/bmjopen-2017-018896
The Ottawa Hospital, (2020). Decision Aid Summary. https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=tv6530
Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014).Patient Involvement in Health Care Decision Making: A Review.Iran Red Crescent Med J. 2014 Jan; 16(1): e12454. doi: www.10.5812/ircmj.12454
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Discussion: 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:
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 https://decisionaid.ohri.ca/.
Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
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.
By Day 3 of Week 11
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences 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.Rubric Detail
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Name: NURS_6052_Module06_Week11_Discussion_Rubric
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Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100