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Discussion 1 I have experienced patient involvement in treatment and healthcare decisions for a patient with diabetes who wanted more information on patient education and self-management.

Discussion 1 I have experienced patient involvement in treatment and healthcare decisions for a patient with diabetes who wanted more information on patient education and self-management.

Discussion 1

 

I have experienced patient involvement in treatment and healthcare decisions for a patient with diabetes who wanted more information on patient education and self-management. Still, there is a challenge to prioritize patients’ preferences and professional when patients lack information and knowledge.  The diabetic patient wished to be involved in shared decision-making. Preferences are one of the considerations in shared decision-making, including treatment and management decisions. Trust in physicians and nurses likely influenced the patient’s willingness to participate in shared decision-making.

Evaluating what influences patient preferences for participating in healthcare decisions is helpful to promote informed decision-making as there would be a focus on facilitating shared decision-making. Meeting patients’ needs and evaluating their preferences should be a top priority, and promoting patient engagement makes it easier to determine patient preferences. In decision-making, it is necessary to consider the benefits and risks of decisions and patient preferences to inform patient decisions and involvement (Friedrichs et al., 2016). Patient preferences are increasingly prominent in shared decision-making about care and treatments, and getting informed is necessary to reduce knowledge deficit and make decisions based on the best evidence.

Even if patients engage in active decision-making, using the best evidence to support clinical decisions is necessary. Thus, in the case of the diabetic patient, it was necessary to respect the patient’s autonomy preferences while exercising professional judgment. Patient preferences can influence treatment choice, and in patient-centered care, there is a focus on supporting patients and families to make informed decisions (Lindsay et al., 2020). Patient-centered communication, patient education, and empowerment facilitate shared decision-making. Hence, patients and families make informed health care decisions, and patient-centeredness is essential for promoting high-quality health care.

The Ottawa Hospital Research Institute inventory of decision aids is one tool that facilitates clarifying patient choices and using the best evidence to support decisions. Personalizing patient decisions and enabling patient involvement is one of the benefits when using the decision aid. Diabetes is one of the specific conditions in the decision aid, and the type of decision aid is treatment, and the target audience is adults with diabetes type 2 (Ottawa Hospital Research Institute). Patient decision aids present individualized information and interventions tailored to the patients’ needs.

References

Friedrichs, A., Spies, M., Haerter, M., & Buchholz, A. (2016). Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature. PloS one11(1), e0145817.

Lindsay, S. E., Alokozai, A., Eppler, S. L., Fox, P., Curtin, C., Gardner, M., … & VOICES Health Policy Research Investigators. (2020). Patient preferences for shared decision making: not all decisions should be shared. The Journal of the American Academy of Orthopaedic Surgeons28(10), 419.

Ottawa Hospital Research Institute. Decision Aids Inventory. Retrieved from

https://decisionaid.ohri.ca/

Discussion 2

 

Important Factors of Patient Education

Patient health outcomes should be a joint decision making process in which healthcare teams and patients collaborate to reach a common outcome.  Joint decision making offers a structured method to incorporate evidence as well as patient values and preferences into medical decision making (Grad et al., 2017).  As an acute care nurse on a surgical floor,  I strongly believe in collaborating with my patients to ensure the patients are discharged with all the resources they need and understand their current health conditions to improve their health.  

I consider many of my patients to be the best source of information about their health conditions.  They know their diets, physical capabilities, living environments, and daily life styles that the healthcare teams need to understand and develop plans to reach desirable patient outcomes.  Although many patients collaborate with their healthcare team, there are several that choose not to follow given directions to improve their lives.  For some, it takes a serious medical condition to change their habits.

 One situation in which a patient and the interdisciplinary team attempted to collaborate with was a diabetic patient who was admitted for osteomyelitis associated with diabetic vascular disease.  The patient underwent right foot amputation due to osteomyelitis.  The vascular surgery team, diabetic educator, and I educated the patient on following his diabetes regimen and controlling his diet at home or his vascular disease will advance, leading to further amputations.  Several months after his discharge, he was readmitted for a below the knee amputation (BKA).  When I spoke to the patient, he stated that he did not follow the teams instructions and did not change his diet, but now that he had his BKA, he stated that he will now follow the guidelines provided by his team.  

 After this patient’s outcomes, I thought about why the patient did not follow the team’s instructions on controlling his diabetes.  I thought that maybe our educational methods did not suit his life style and his needs at home.  I spoke with our diabetes nurse educator and asked her if we should have approached the patient’s treatment plan in a different way compared to other diabetic patients.  I thought maybe if we listened to his daily routines and diet, we could have formulated a patient specific diet plan, including the patient’s preferences and life values (Chester et al., 2018).  After my experiences with this patient, I decided to listen more about my patients’ daily life styles and preferences rather than teaching them about basic diabetes guidelines.  

References

Bae, J. M. (2017).  Shared decision making: relevant concepts and facilitating strategies.  Epidemiology and

            Health, South Korea, 39, e2017048.  Doi: 10.4178/epih.e2017048

Chester, B., Stanley, W. G., & Geetha, T. (2018).  Quick guide to type 2 diabetes self-management education:

            creating an interdisciplinary diabetes management team.  Diabetes, Metabolic Syndrome and Obesity:

            Target and Therapy, 11, 641-645.  Doi: 10.2147/DMSO.S178556

Grad, R., Legare, F., Bell, N. R., Dickinson, J. A., Singh, H., Moore, A. E., Kasperavicius, D., & Kretschmer, K.

            L. (2017).  Shared decision making in preventative health care: what it is; what it is not.  The Official

           Journal of the College of Family Physicians of Canada, 63(9), 682-684.  Retrieved from 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597010/


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