Introduction
The health care sector upholds the importance of shared decision-making in successful treatment processes. It is defined as the process through which health professionals collaborate with the patients in making critical decisions regarding the patient health and treatment (Kon et al., 2016). Another study by Hoffman et al. (2014) states that shared decision-making is an important approach to health care practice and should be integrated into evidence-based medicine. In this study, I review a case study of patient X, whom I encountered within my practice, how inclusion and omission of shared decision-making were done, and how it affected the treatment process.
Scenario
Patient X was an Australian man who had traveled to the United States to marry his United States girlfriend. He was a middle-aged man and had collapsed a few days after they were married. Although the patient was in critical condition and could not communicate verbally, he was cognitively active. He could write information as a method of communication. After some time in the hospital, the wife abandoned him, and the hospital had to contact relatives from Australia. His condition worsened, and due to depression, he suffered from cardiac arrest. The patient stayed in the hospital unit for ten months, and the nurses would change the room settings or transfer him to another room to make him happy. Finally, after his condition improved, the hospital decided to take him back to Australia with its own money. The wife denied any association with the patient, and the hospital had to take her to court to receive the total amount of money the patient used.
Impact of Inclusion and Omission of Shared Decision Making
From the case scenario, including the patient and his family in decision-making improves his condition. In his first stage, the man communicated through writing, and the wife was also present to aid in decision-making. The patient’s condition at this stage was stable. However, when their wife abandoned him, he became depressed, and his condition worsened. Since he could not decide on treatment at this stage, the hospital contacted his Australian family. However, sending the patient back to Australia was problematic since the hospital did not involve the patient or the family and thus ended up in a conflict between the wife and the hospital. Kon et al. (2014) found that in some scenarios where the patient’s condition is complicated and the family is not collaborative, shared decision-making in health care is challenging to implement.
Patient Values and Preferences
Lang et al. (2018) state that practitioners need to understand the patients’ values and how they perceive the benefits and harms of treatment. In my scenario, the practitioners did not have enough information on the patient’s values and preferences since the wife refused to collaborate. However, they incorporated the less information they acquired from his family back in Australia. Failure to have in-depth information on patient X’s values and preferences contributed to the prolonged stay in the hospital and slow recovery.
Decision Making Aid
Schroy et al. (2014) argue that decision aids enhance shared decision-making by improving the quality and efficiency of the treatment. In this case, the practitioner used the decision aid since the patient had little influence in decision-making due to his critical condition. For example, I used the Ottawa Hospital Research Institute (2019) decision aid on how to reduce depression in older adults. The patient was suffering from depression, and therefore, it was necessary to cheer him up by changing his bedridden environment, and his condition improved.
Conclusion
In conclusion, I have learned that shared decision-making in health care is paramount for the health improvement of patients. However, it is hard to implement it sometimes and leads to poor patient health care and patients’ and their families’ conflicts with the hospital. Therefore, families are encouraged to participate in their patients’ decision-making in the case of critical health conditions. Therefore, family and patient collaboration in health decision-making should be encouraged and supported in all hospitals.
References
Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Jama, 312(13), 1295-1296. Web.
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision-making in intensive care units. Executive summary of the American College of Critical Care Medicine and American Thoracic Society policy statement. American Journal of Respiratory and Critical Care Medicine 193(12), 2-3. Web.
Lang, E., Bell, N. R., Dickinson, J. A., Grad, R., Kasperavicius, D., Moore, A. E.,… & Stacey, D. (2018). Eliciting patient values and preferences to inform shared decision making in preventive screening. Canadian Family Physician, 64(1), 28-31. Web.
Schroy III, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27-35.
The Ottawa Hospital Research Institute. (2019). Patient decision aids. Web.