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Nurse-Patient Partnership

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by

John Hodge

on 17 December 2012

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Transcript of Nurse-Patient Partnership

Patient Involvement and
Shared Decision Making Empowering Patients
in Healthcare Decision making is a process which requires weighing up options (deliberation) and committing to a decision (determination).
- Thompson (2007)

There are three different models of decision making:

The Paternalistic Model
The Consumerist Informative Model
The Shared Decision Making Model
- Moreau et al (2012) Decision Making Shared Decision Making Some Barriers to Shared Decision Making A process whereby patients have the knowledge, skills, attitudes and self-awareness necessary to influence their own behaviour and that of others in order to improve the quality of their lives.
- Funnell et al (1991) Patient Empowerment Empowered patients are concordant with their treatment rather than compliant with it.

However there are some difficulties for HCPs:
Requires HCPs to actively engage as partners with patients in writing self management plans.
HCPs move from being 'experts' to 'facilitators'.
Requires patient-centredness and shared decision making.
HCPs can be concerned about the ethics of taking a step back and watching patients take decisions they percieve are not 'right'.
- Asimakopoulou et al (2012) Patient Empowerment This presentation will discuss why it is important that nurses involve their patients in decisions about and delivery of their care.

Objectives:
To outline the different models of decision making.
To highlight the difficulties HCPs and patients have in sharing decision making.
To explain the concept of patient empowerment.
To discuss ways in which patients are empowered and why they sometimes are not.
To relate these discussions to diabetes care and the change we would like to make. Aims & Objectives The current policy orthodoxy in the UK is that patient's need to be more involved in decisions about their care and in the delivery of it (Cribb, 2012).

One of the key priorities in 'The Healthcare Quality Strategy for NHSScotland' (The Scottish Government, 2010) was:
Effective collaboration between clinicians, patients and others. Diabetes care is an area of healthcare that has pioneered patient healthcare (Cribb, 2012).

Nurses have a role to play in encouraging and supporting patients to self manage their diabetes.
They can do this by providing support which is:
Practical
Empathetic
Patient specific
- Oftedal et al (2010) Diabetes Care and Patient Involvement Nurses working in partnership with patients to can promote empowerment by providing:
Information
Support
Resources

It has also been argued that if nurses feel more empowered themselves they are more likely to empower patients.
Spence Laschinger et al (2010) How Can Patient's Become Empowered? References Asimakopoulou, K., Newton, P., Sinclair, A. and Scambler, S. 2012. Health care professionals’ understanding and day-to-day practice of patient empowerment in diabetes; time to pause for thought? Diabetes Research and Clinical Practice, 95, pp.224–229.
Cribb, A. and Entwistle. 2011. Shared decision making: trade-offs between narrower and broader conceptions. Health Expectations, 14, pp.210–219.
Cribb. A. 2011. Involvement, Shared Decision-Making and Medicines. London: Centre for Public Policy Research, King’s College London.
Funnell, M., Anderson, R., Arnold, M., Barr, P., Donnelly, M. and Johnson, P. 1991. Empowerment: an idea whose time has come in diabetes education. Diabetes Education, 17, pp.37–41.
Moreau, A., Carol, L., Dedianne, M., Dupraz, C., Perdrix, C., Lainé, X. and Souweine, G. 2012. What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews. Patient Education and Counseling, 87, pp.206–211.
Oftedal, B., Karlsen, B. and Bru, E. 2010. Perceived support from healthcare practitioners among adults with type 2 diabetes. Journal of Advanced Nursing, 66(7), pp.1500–1509.
Spence Laschinger, H., Gilbert, S., Smith, L. and Leslie, K. 2010. Towards a comprehensive theory of nurse/patient empowerment: applying Kanter’s empowerment theory to patient care. Journal of Nursing Management, 18, pp.4–13.
The Scottish Government. 2010. The Healthcare Quality Strategy for NHSScotland. Scotland: The Scottish Government.
Thompson, A. 2007. The meaning of patient involvement and participation in health care consultations: A taxonomy. Social Science & Medicine, 64, pp.1297–1310. Preferred method for decision making in healthcare.

Patients and HCPs are autonomous and responsible.

It has been proposed it involves:
Eliciting patient preferences
Discussion and joint deliberation
Synthesising evidence base and patient preferences

- Cribb and Entwistle (2011) Not all patients want to be involved in decision making.
Involves patient and HCP building a good relationship with mutual trust.
It is often used by HCPs to 'persuade' patients to agree with their perspective.
There are often time
constraints.
- Moreau et al (2012) The Policy Picture Guess Who? Conclusion This presentation has discussed at:
Shared decision making
Patient empowerment
Barriers to the implementation them
How they can relate to diabetes and our planned change. Any Questions
Full transcript