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Health, Medicine, Nursing
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Patient Preferences and Decision-Making Health, Medicine Paper (Other (Not Listed) Sample)


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.


Discussion: Patient Preferences and Decision Making
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Discussion: Patient Preferences and Decision Making
My experience with patient preference and values in healthcare decision-making occurred when working in private practice. Patient A came in for a check-up accompanied by his concerned wife. His blood pressure was 139/83 mmHg, indicating stage 1 hypertension. The patient did not have any comorbid condition or extraneous risk factors to necessitate medication, and the physician correctly recommended exercise and dietary changes to manage the condition, without any further discussion. However, the patient’s wife had researched hypertension and was alarmed that the value was above 120/80 mmHg. She expressed her concerns about the absence of medicinal support to her husband, who then confronted the doctor.
Patient A felt that the physician acted rashly in assuming that he did not need medication. He argued that the doctor knew he was a busy man, and recommending exercise instead of medication was inconsiderate. The doctor tried to explain, but the patient’s agitation prevented amicable communication. Patient A threatened to stop visiting the doctor’s practice and left. A few days later, he returned without his wife to speak to the doctor. He requested medication instead of lifestyle changes, but the doctor insisted on the recommended treatment plan. Three months later, follow-up tests showed that the condition had worsened. Patient A revealed that he had not kept up with the prescribed exercise and had obtained over-the-counter medication instead.
The failure to incorporate his beliefs and preferences in the initial recommendation contributed to the patient’s deterioration. His negative attitude towards exercise derived from his wife’s insistence that a medical alternative to manage his condition would be a more viable option. An open discussion with the physician about the options available for treatment would have resulted in a positive attitude towards exercise. Additionally, Patient A would not have resorted to over-the-counter medication if he had been fully informed about the reasons for the doctor’s decision. In this case, the failure to incorporate patient preference and values in the health decision negatively impacted the health outcome. This case shows that healthcare workers must provide timely and accurate information to their patients to prevent them from willful action that may compromise their condition.
The above case compelled the physician to reassess her approach, and prioritize patient preference and values within the healthcare decision-making process. Once a nurse explained to Patient A, he understood that the preferred approach is to avoid medication and its side-effects if a lifestyle change would be effective, and he made the necessary adjustments to accommodate the change. The nurse highlighted the fact that even with medication, the patient would still need to exercise. This approach reassured the patient that the staff considered his preferences and that they would be implemented in his treatment whenever possible. At the next three-month check-up, the patient’s blood pressure had stabilized, and he had lost weight because of his fitness program, which is evidence that incorporating patient preferences and values improves their buy-in into a treatment program (Coulter et al., 2017; Tibebu et al., 2017). The tangible benefits of involving patients in health decision-making cannot be ignored simply to save time.

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