Advanced Patient Care
COMMENT 1:
In 1973, the American Hospital Association established the Patient’s Bill of Rights, which safeguards the patient’s right to be informed and involved in therapeutic decisions. To date, the model that depicts this purpose is the shared decision-making (SDM) model. At the model’s base, there is respect for the principle of individual self-determination as a desirable objective for patients, and professionals should try to attain this goal. Under this model, patients make choices with their healthcare providers (nurses, doctors, etc.) based on the best available data. Patients are urged to think about their clinical examinations, available treatments, choices, and the benefits or downsides of every option to voice their preferences and support healthcare providers in decision-making (Galletta et al., 2022).
Patients have far more control over their healthcare thanks to improved information availability and a move toward patient-centered care. The rise of digital health solutions, such as online medical records, telehealth, and health apps, empowers consumers to participate actively in care decisions. Modern healthcare emphasizes collaborative decision-making, where patients interact with clinicians to establish tailored treatment regimens. Enhanced health literacy and advocacy for patient rights have also contributed to this shift, allowing individuals to understand their conditions better, seek second opinions, and choose treatments aligning with their values and preferences, leading to improved health outcomes and satisfaction (Kadaei,2024).
COMMENT 2
Patient participation in their own health implies the involvement of the patient in the decision-making or expressing their opinions about different treatment alternatives, including sharing information, feelings, and preferences (Vahdat, Hamzehgardeshi, Hessam, & Hamzehgardeshi, 2014). The patient’s involvement in the decisions concerning their own health has increased over the years. The patients are now empowered with the knowledge about their rights and have the information necessary for making informed health decisions. Besides, the patients are expected to engage actively in the management of their health in collaboration with healthcare providers. The patients now have more control over their own health care, unlike before, when decisions were made on their behalf (Falvo, 2011). This is because, in the past, the patient we perceived as passive recipients of care. The patients were not expected to take part actively in their health care. However, this has changed drastically since patients can now demand quality care and ask questions about their health. The patient’s participation in treatment and decision-making in health care has become a political necessity in many health care systems across the world (Vahdat et al., 2014). The current health care system is patient-centered since the care is provided according to the patient’s preferences, values, and beliefs. Healthcare providers must involve the patient in the decision-making process. The providers should also include the patient and their family members in health care decisions.
COMMENT 3
Patients’ control over their healthcare has significantly evolved over the past few decades. Previously, healthcare was predominantly provider-driven, with patients having minimal input in decision-making processes. Patients were seen as passive recipients of healthcare. Well-meaning health professionals withheld information about patients’ health and healthcare, justifying this with statements such as patients cannot comprehend it, full disclosure would cause patients unnecessary worry, and patients aren’t interested in knowing all the details, which is why they seek professional advice (Falvo, 2011). Today, however, a shift towards patient-centered care has empowered individuals to take a more active role in managing their health.
This transformation is largely due to increased access to information. The internet and digital health platforms provide patients with a wealth of knowledge about medical conditions, treatment options, and preventative measures, changing their view about the healthcare professional as the final authority (Falvo, 2011). Patients can make informed decisions and engage in meaningful discussions with their healthcare providers with this information. Additionally, advancements in technology have introduced tools like wearable devices and health apps, enabling individuals to monitor their health in real-time. These innovations foster a sense of agency, as patients can track their progress, set health goals, and receive personalized feedback.
Vahdat et al. (2014) posit that the factors influencing patient participation included elements related to healthcare professionals, such as the doctor-patient relationship, acknowledging the patient’s knowledge, and providing adequate time for participation. Additionally, factors related to patients themselves, such as their knowledge, physical and cognitive abilities, emotional connections, beliefs, values, and experiences with health services, also played a significant role.
The shift towards shared decision-making reflects a cultural change in healthcare that values patient autonomy. As a result, patients today are not just passive recipients of care but active participants, negotiating, making informed decisions, and advocating for their health and well-being.
COMMENT 4
Before the 1970s, physicians had the autonomy to make decisions for medical treatments for patients entirely. It is a paternalistic model in which healthcare professionals make health decisions and care for patients without consent. In modern medicine, patients have the autonomy to know their medical disease process and treatment plans and consent to health care providers. For instance, the provider will explain the method to the patients before a procedure. They will also explain the benefits, risks, and expectations after the procedure. This allows the patients to know more about their disease process, the risks, and the health improvements they may have after the procedure. Patient autonomy is significant and can help patients make the final decisions about their health interventions (Molina-Mula & Gallo-Estrada, 2020). Some patients may wish to discontinue all medical treatments and enter hospice or palliative care. Providers should respect the patient’s wishes and not encourage treatments. The patient’s right is to know about their disease process and make the final health decision. This will satisfy their needs and preferences and allow them to feel comfortable daily (Houska & Lou?ka, 2019)
COMMENT 5
In the healthcare sector, the ability to convey complex information clearly and negotiate effectively is of utmost importance, especially for nurses who are at the forefront of patient interactions and care coordination. The art of communication for nurses goes beyond bedside manner; it extends to the strategic discussions in the boardroom where policies and decisions are made. This comprehensive skill set is essential for ensuring that patient needs and nursing perspectives are accurately and convincingly expressed in both clinical and administrative settings, despite the inherent challenges of the healthcare environment (“Nursing Care Communication and Negotiation: From Bedside to Boardroom: Nurse Communication in Business,” 2024).
Negotiation plays a significant part in patient education by building a collaborative relationship between healthcare practitioners and patients. Through negotiation, healthcare providers can understand patients’ preferences, opinions, and concerns and incorporate them into the care plan. This method requires active listening, sympathetic communication, and mutual respect, ensuring patients feel heard and respected. By negotiating treatment alternatives, healthcare providers can adapt education to fit individual needs, promote patient involvement, and enhance adherence to medical recommendations. Negotiation encourages people to actively participate in their health, resulting in more individualized, effective, and satisfactory healthcare outcomes. However, there are situations when patients and health professionals may be unable to find an acceptable compromise even when consideration of alternatives would be viable. Sometimes, even the best attempts to grasp the patient’s perspective may result in an impasse (Falvo, 2011).
COMMENT
Negotiation is a give and take concept. It allows the patient to have control over their treatment under the direction and supervision of a healthcare provider. The term “negotiate” implies conferring with another in order to reach a compromise (Falvo, 2011).
Bargain: In order to bargain, you need to have something to offer in exchange for what you want. According to On Demand Films in their youtube video titled Communicating with Aged-Care Residents, communication is the exchange of information. By asking the patient/client if they have any concerns regarding their care of issues they want addressed, you open up the opportunity to educate them. The patient/client gives their concerns/requests and receives advice/help/education in return. The healthcare provider gives their time/attention/wisdom/knowledge and receives patient/client engagement/participation and compliance/adherence to treatment.
There are various ways in which this feedback loop can occur:
Communicate ? bargain ? negotiate ? agree ? exchange then loop back to communicate.
OR
Exchange ? communicate ? bargain ? negotiate ? agree then loop back to exchange.
Agree ? negotiate ? bargain ? communicate ? exchange then loop back to agree or wherever it pleases either party to begin.
The above loop feedback systems do not occur in a linear fashion and participants can hop from one part of the process to the other by improvising and adapting as they go.
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