Patient Preferences and Decision Making

 

 

Throughout the years, healthcare has evolved and advanced in several forms, more specifically, making the transition from clinician-centered care to patient-centered care. According to Melynk and Fineout-Overholt (2018), patient-centeredness is a key component to incorporate patient preferences into practice and values decision-making supported by evidence-based research. Healthcare providers involve their patients in every aspect of the decision-making of their care and the involvement should be respected and sympathetic to each patient’s preferences, needs, and values (Melnyk & Fineout-Overholt, 2018). Patient involvement in the decision-making process of their care results in improved treatment outcomes and activities of daily living (Vahdat et al., 2014)
`In my current organization, I recall a situation where I experienced incorporating patient preferences and values that impacted the outcome of their treatment plan. One of my patients in his early 40s had intermittent unexplained syncope episodes, lightheadedness, and chronic fatigue most of his life. He was referred to the cardiology unit, where he was diagnosed with Brugada syndrome. Brugada syndrome is a genetic disorder that can cause dangerous irregular heartbeat. His cardiologist recommended an Implantable cardioverter-defibrillator (ICD). The procedure and the equipment were explained in detail to the patient that an ICD, if implanted, will constantly check heart rate and rhythm, and fix a dangerous abnormal heart rhythm, thereby preventing sudden death. As soon as the patient heard the news, he had mixed feelings about the procedure. Her family and I reassured him that if he agreed to an ICD, it would aid in prolonging his life by regulating his heart rhythm. He asked several questions regarding the pros and cons of the procedure. I provided him with educational pamphlets relating to ICD and assured him that healthcare providers would respect whatever decision he made. After weighing both pros and cons, he decided that he wanted to get the procedure done. He later expressed his gratitude for providing the support and educational needs to help him make the procedure’s final decision.
After reviewing the Ottawa Hospital Research Institute’s Decision Aids, I came across patient decision aid which was Heart Rhythm Problems: Should I Get an Implantable Cardiovascular-Defibrillator (ICD)? (Ottawa Hospital Research Institute, 2019). This patient decision aid is intended for individuals considering getting an ICD with heart rate issues but not for those diagnosed with heart failure (Ottawa Hospital Research Institute, 2019). It also provides excellent resources regarding the options of getting an ICD, key points to remember about ICD, and a section that discusses frequently asked questions. Furthermore, my patient would have benefitted from this tool to help encourage him to conduct more research about an ICD, ease his anxiety, and provide the utmost reliable source of information to make a sensible decision.

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