Discussion: Patient Preferences and Decision Making Essay
Discussion: Patient Preferences and Decision Making Essay
Patient preferences and values can be social, cultural, religious, or spiritual values, and the patient’s thoughts about what entails personal priorities, quality of life, and beliefs about health. A 45-year-old male patient presented to the outpatient clinic with complaints of insomnia. He reported having problems finding sleep and had frequent nighttime awakenings. Insomnia had affected his job since he would often nod off at his desk as early as 10 am. He had taken OTC diphenhydramine, which a colleague had recommended to help him sleep. However, he did not continue taking it since he experienced morning drowsiness. When discussing treatment options with the patient, he requested that the drug prescribed should have no diphenhydramine as an ingredient.
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The preceptor commonly prescribes Hydroxyzine to middle-aged patients with insomnia. However, he did not prescribe it for this patient since it is an antihistamine with strong sedative properties associated with drowsiness. Besides, the preceptor wanted to respect the patient’s preferences since it increases medication adherence. Consequently, the preceptor prescribed Trazodone, an off-label drug, to manage his insomnia (Pagel et al., 2018). During the follow-up visit, the patient reported that Trazodone was effective in managing insomnia and reported no adverse effects. He mentioned that he took the drug as prescribed and ensured he never missed a dose. If the preceptor had failed to consider the patient’s preferences and prescribed Hydroxyzine as she does to other patients, the side effects would have limited adherence. Thus, the desired treatment outcomes would not have been achieved.
The selected patient decision aid is Insomnia: Should I Take Sleeping Pills? The aid targets individuals considering using sleeping pills for insomnia. It provides two options: Take sleeping pills for a short time alongside lifestyle modification and Treat sleep problems with only lifestyle changes (Ottawa Hospital Research Institute, 2019). The decision aid can help clinicians to make effective decisions when managing patients with insomnia by guiding them on whether to prescribe medications or sleep hygiene interventions. I can use the tool in my future FNP practice in managing clients with insomnia and determining the patients to recommend pharmacotherapy and those for psychotherapy.
References
Ottawa Hospital Research Institute. (2019, June 26). A to Z summary results. Patient Decision Aids – Ottawa Hospital Research Institute. https://decisionaid.ohri.ca/AZsumm.php?ID=1085
Pagel, J. F., Pandi-Perumal, S. R., & Monti, J. M. (2018). Treating insomnia with medications. Sleep Science and Practice, 2(1), 1-12. https://doi.org/10.1186/s41606-018-0025-z
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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.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare:
- Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
- Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
- Choose “For Specific Conditions,†then Browse an alphabetical listing of decision aids by health topic.
- NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.
BY DAY 3 OF WEEK 11
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.
Course resources are linked below.
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Criteria | Ratings | Pts | ||||
Main Posting |
50 to >44 pts Excellent | 44 to >39 pts Good | 39 to >34 pts Fair | 34 to >0 pts Poor | ||
Answers all parts of the discussion question(s) expectations
with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. … Supported by at least three current, credible sources. … Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Responds to
the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. … At least 75% of post has exceptional depth and breadth. … Supported by at least three credible sources. … Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Responds to some of the discussion
question(s). … One or two criteria are not addressed or are superficially addressed. … Is somewhat lacking reflection and critical analysis and synthesis. … Somewhat represents knowledge gained from the course readings for the module. … Post is cited with two credible sources. … Written somewhat concisely; may contain more than two spelling or grammatical errors. … Contains some APA formatting errors. |
Does not respond to the discussion question(s) adequately. … Lacks depth or superficially
addresses criteria. … Lacks reflection and critical analysis and synthesis. … Does not represent knowledge gained from the course readings for the module. … Contains only one or no credible sources. Not written clearly or concisely. … Contains more than two spelling or grammatical errors….. Does not adhere to current APA manual writing rules and style. |
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view longer description | / 50 pts |
Criteria | Ratings | Pts | |||
Main Post: Timeliness view longer description | 10 to >0 pts Excellent
Posts main post |
by day 3. |
0 pts Poor
Does not post by |
day 3. |
/ 10 pts |
First
Response view longer description |
18 to >16 pts Excellent
Response exhibits synthesis, |
16 to >14 pts Good
Response exhibits critical |
14 to >12 pts Fair
Response is on topic and may have some |
12 to >0 pts Poor
Response may not be on topic and lacks |
/ 18 pts |
critical | thinking and | depth. … | depth. … | ||
thinking, and | application to | Responses | Responses | ||
application to | practice | posted in the | posted in the | ||
practice
settings. … |
settings. …
Communicatio |
discussion
may lack |
discussion lack
effective |
||
Responds fully | n is | effective | professional | ||
to questions | professional | professional | communicatio | ||
posed by | and respectful | communicatio | n. … | ||
faculty. …
Provides clear, |
to colleagues.
… Responses |
n. …
Responses to |
Responses to
faculty |
||
concise | to faculty | faculty | questions are | ||
opinions and | questions are | questions are | missing…… No | ||
ideas that are | answered, if | somewhat | credible | ||
supported by
at least two |
posed. …
Provides clear, |
answered, if
posed. … |
sources are
cited. |
||
scholarly | concise | Response may | |||
sources. … | opinions and | lack clear, | |||
Demonstrates | ideas that are | concise | |||
synthesis and
understanding |
supported by
two or more |
opinions and
ideas, and a |
|||
of learning | credible | few or no | |||
objectives. … | sources. … | credible | |||
Communicatio | Response is | sources are | |||
n is
professional |
effectively
written in |
cited. | |||
and respectful | standard, | ||||
to colleagues. | edited English. | ||||
… Responses
to faculty |
|||||
questions are | |||||
fully | |||||
answered, if | |||||
posed. … |
Criteria | Ratings | Pts | ||||
Response is effectively written in standard, edited English. | ||||||
Second Response
view longer description |
17 to >15 pts Excellent
Response exhibits synthesis, |
15 to >13 pts Good
Response exhibits critical |
13 to >11 pts Fair
Response is on topic and may have some |
11 to >0 pts Poor
Response may not be on topic and lacks |
/ 17 pts | |
critical | thinking and | depth. … | depth. … | |||
thinking, and | application to | Responses | Responses | |||
application to | practice | posted in the | posted in the | |||
practice
settings. … |
settings. …
Communicatio |
discussion
may lack |
discussion lack
effective |
|||
Responds fully | n is | effective | professional | |||
to questions | professional | professional | communicatio | |||
posed by | and respectful | communicatio | n. … | |||
faculty. …
Provides clear, |
to colleagues.
… Responses |
n. …
Responses to |
Responses to
faculty |
|||
concise | to faculty | faculty | questions are | |||
opinions and | questions are | questions are | missing…… No | |||
ideas that are | answered, if | somewhat | credible | |||
supported by
at least two |
posed. …
Provides clear, |
answered, if
posed. … |
sources are
cited. |
|||
scholarly | concise | Response may | ||||
sources. … | opinions and | lack clear, | ||||
Demonstrates | ideas that are | concise | ||||
synthesis and
understanding |
supported by
two or more |
opinions and
ideas, and a |
||||
of learning | credible | few or no | ||||
objectives. … | sources. … | credible | ||||
Communicatio | Response is | sources are | ||||
n is
professional |
effectively
written in |
cited. | ||||
and respectful | standard, | |||||
to colleagues. | edited English. | |||||
… Responses | ||||||
to faculty
questions are |
||||||
fully | ||||||
answered, if | ||||||
Criteria | Ratings | Pts | ||
posed. …
Response is effectively written in standard, edited English. |
||||
5 to >0 pts | 0 pts | |||
Participation | Excellent | Poor | ||
view longer description | Meets requirements for
participation by posting on three |
Does not meet requirements for
participation by posting on 3 |
/ 5 pts | |
different days. | different days. |