Assignment Task:
Discussion: Patient Preferences and Decision Making
Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
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.
To Prepare:
1. 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.
2. Review the Ottawa Hospital Research Institute's Decision Aids Inventory
- Choose "For Specific Conditions," then Browse an alphabetical listing of decision aids by health topic.
3. After you have chosen a topic (or condition) and a decision aid, consider if social determinants of health were considered in the treatment plan Social determinants of health can affect a patient's decision as these are conditions in the patient's environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context.
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.
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of health, and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, 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.
(Please Note: The underlined "social determinants of health" in the above content is meant to hotlink to the following Walden webpage and content:
Social Determinants of Health - Social Determinants of Health - Academic Guides at Walden University)
Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.
Required Readings:
- Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312 (13), 1295-1296.
- Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44 (1), 188-201.
- Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32 (4), 176-184.
- Schroy, 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
Separately Reply To Colleague Responses Below:
Karen Yvonne White (She/Her)
Reply from Karen Yvonne White
During my time as a pediatric registered nurse, I encountered a case involving a 12-year-old patient with poorly controlled asthma. The child's mother frequently brought him to the emergency department for exacerbations, yet controller medication adherence remained low. When the care team initially developed the treatment plan, the mother was not fully involved in the decision-making process. The provider primarily explained the medication changes without addressing barriers such as medication cost, transportation issues, and the family's limited health literacy. Consequently, the patient continued to miss follow-up appointments and relied on emergency services for acute management.
When I later engaged the family more directly, I recognized several social determinants of health (SDOH) influencing their decisions, limited economic stability, inconsistent access to a local pharmacy, and a lack of understanding about inhaler technique. Once these issues were acknowledged, the treatment plan was revised to include a more affordable generic inhaler, a referral to a community pharmacy that offered delivery, and a teaching session using visual demonstrations. Incorporating the mother's preferences and addressing SDOH resulted in improved adherence and fewer emergency visits over the next several months.
Recent research highlights the importance of involving patients and their families in shared decision-making (SDM) to enhance outcomes and satisfaction. Gijsen et al. (2025) developed a pediatric asthma SDM tool that integrated family preferences and contextual factors, demonstrating better alignment between prescribed treatments and daily life. Similarly, Kang et al. (2024) found that SDM enhances adherence and trust by ensuring patients' socioeconomic and educational circumstances are considered throughout the decision process.
Had patient preferences and contextual factors been incorporated from the outset, the care trajectory might have differed dramatically. Shared decision-making fosters trust, enhances self-efficacy, and aligns treatment with the patient's capabilities and values. It also encourages patients and caregivers to take ownership of chronic disease management, which is especially critical in pediatric asthma care.
From the Ottawa Hospital Research Institute's Decision Aid Inventory, I selected the "Asthma Medication Decision Aid" (Ottawa Hospital Research Institute, n.d.), which helps patients weigh the pros and cons of different controller and rescue medications. This tool guides patients through clarifying their priorities-such as minimizing side effects, improving control, or reducing cost-and provides evidence-based comparisons of treatment options.
Using this aid in the described situation could have empowered the patient's mother to better understand medication choices, clarify her concerns, and actively participate in selecting a regimen that fit her lifestyle and finances. More broadly, decision aids enhance communication between clinicians and patients, reduce decisional conflict, and support informed consent grounded in personal values (Gijsen et al., 2025).
In my professional practice as a pediatric nurse and future Nurse Educator, I plan to use the Decision Aid Inventory as a reference when counseling families about chronic disease management options, especially when discussing long-term therapies such as inhaled corticosteroids, immunizations, or nutritional interventions. Personally, I find these aids valuable for navigating my own or my family's health decisions, as they ensure that every choice reflects both evidence and individual priorities.
References:
Gijsen, C. E. W., Bodewes, A. J. A., van den Berg, J. M., &Snoeck, H. (2025). Development of a paediatric asthma shared decision-making tool. BMC Medical Informatics and Decision Making.
Kang, H., Hansen, B., & Bridgman, R. (2024). The experience of shared decision-making for people with asthma: A systematic review and qualitative synthesis. Health Expectations, 27(3), 1023-1035.
Ottawa Hospital Research Institute. (n.d.). A to Z inventory of decision aids.
U.S. Department of Health and Human Services. (2023). Social determinants of health. Healthy People 2030.
Jorge Granda Delgado
Reply from Jorge Granda Delgado
In my clinical placement, I worked with a 63-year-old patient, whom I shall refer to as Mr. Lopez, who had recently been diagnosed with colorectal cancer. The medical staff had prescribed surgery prior to chemotherapy, but the patient was hesitant since he had financial constraints, transportation difficulties, and a limited family support system. All these factors were examples of social determinants of health (SDOH), and they played a crucial role in his readiness to start treatment.
First, the healthcare staff concentrated on the medical nature of the illness without paying much attention to the personal and social life of Mr. Lopez. Consequently, the patient delayed the initiation of treatment, causing disease progression and the development of an unfavorable prognosis. Kon et al. (2016) state that shared decision making (SDM) positively influences clinical outcomes and reinforces the therapeutic relationship since it enables patients to actively engage in the decision-making process that reflects their values and living conditions. The barriers that influenced adherence to treatment could have been minimized through the inclusion of a social worker's intervention, financial aid, or community transportation, had the social determinants of health been taken into account in the care plan.
Browsing through the Decision Aid Inventory of the Ottawa Hospital Research Institute, I chose the tool that deals with the screening and treatment of colorectal cancer (Schroy et al., 2014). The tool offers information regarding treatment options, risks, and benefits that are evidence-based, as well as exercises to reflect on the patient's values and preferences. In the case of Mr. Lopez, it would have helped make communication and active involvement more efficient, enhancing his confidence and determination to proceed with treatment.
According to Opperman et al. (2018), educational approaches that emphasize the application of shared decision-making tools contribute to advancing evidence-based practice and improving the quality of care. The introduction of these tools into professional nursing practice provides more equitable and person centered care that is responsive to the social determinants of health. I will also consider the Ottawa Hospital inventory as a tool in my future practice to identify particular aids that can assist in making complex clinical decisions in both my professional practice and in personal or family health decision making.
References:
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in ICUs. Critical Care Medicine, 44(1), 188-201.
Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S. (2018). Measuring return on investment for professional development activities. Journal for Nurses in Professional Development, 34(6), 303-312.
Schroy, 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.