Patient Decision Making In Nursing
INTRODUCTION
The patient-practitioner relationship has undergone several changes in the past decades. It has moved from a paternalistic relationship, in which the practitioner acted as a guardian and made the decisions on behalf of the patient, to a deliberative relationship in which the patient is more autonomous, informed, empowered and involved in decisions regarding his healthcare. [1]
Recently, there has been an increasing interest and research in shared decision making (SDM), which is one of the pillars of patient-centred care. [2]
Research suggests that engaging patients in healthcare decisions makes a significant and permanent difference to healthcare outcomes. [2]
This paper attempts to explore and understand what constitutes the
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They provide an evidence-based guide for patients: they present the decision to be taken, the options available, they highlight the associated harms and benefits and help clarify and communicate the patient 's personal preferences and goals. [11]
They may come in the form of educational literature, videos and interactive tools and can be applied before, during and after visits for medical care, and may be applied to several different medical conditions as well as preventive medicine. Because decision aids play an important role in SDM, a great body of health systems, research groups and companies have been developing them over the years. [12]
Benefits and challenges
SDM is seen as an ethical imperative by the professional regulatory bodies which expect clinicians to work in partnership with patients, communicating unbiased and understandable information on treatment informing and engaging them whenever possible. It is relevant for patients because they want to be more active participants than they currently are in making decisions about their own health.
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[14]
It is not just a matter of learning a few skills, the whole society needs to be changed in order to fully support SDM in the health system. [14]
CONCLUSION
Shared decision making is a complex intervention. Nowadays, it is not yet the norm and many patients want more participation in decisions about treatment, care or support than they currently have.
Now the biggest challenge is to create effective ways for supporting shared decision-making and ensuring it is widely embedded into systems, patients and clinicians ' behaviours.
A number of implementation projects are under way and they will provide with valuable experience on which to base practice in the future. The ultimate goal is that shared decision making is viewed as the core of good clinical practice, with patients placed at the centre of all
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