Decisions Flashcards
What is decisional conflict? and when does this occur
State of uncertainty about course of action. Occurs when pt face uncertainty, feel unsupported, or feel unclear about priorities around a decision
What is decisional conflict exacerbated by? (5 points) and what are the outcomes of decisional conflict (5 points)
• Lack of information
• Insufficient knowledge
• Unrealistic expectations
• Unclear personal values
• Inadequate support and resources
Outcomes:
• Decisional delay
• Dissatisfaction with care
• Regret
• Poor health outcomes
• Blaming
What is decision aids?
Evidence based information, probabilities, benefits/risk analysis, that guides the decision making process
What is decision coaching?
Involves value exploration, guides through the process of a decision, supportive but non-directive
What is decision support?
Structured assistance in reviewing options and discussing it with patients. It’s tailored to pt decisional needs and evidence based info
Coaching vs guidance?
C- provision of support by trained professional in supportive/non directive manner to pt who is facing a decision
G- elements embedded inside support materials that enhance a pt ability to make decisions in self directed manner
8 steps in decision support?
• Clarify the decision to be made.
• Assess decisional needs.
• Provide information and probability of outcomes.
• Present options.
• Clarify personal values.
• Discuss pro’s and con’s.
• Enhance support from others.
• Monitor and facilitate progress
What is international patient decision aids standards (IPDAS)?
Set of criteria that considers quality and development of decision aids that supports reduction of bias.
What is ottawa personal decision guide?
Tool to assist pt facing health decision where no specific aid exists. Doesn’t meet all IPDAS criteria but it’s available in many languages. Useful to help coach/guide pt decision making.
3 different parts of ottawa decision support framework?
- Decisional needs
- Decision support
- Decision outcomes
What is decision coaching?
Provided by trained HCP that is non directive support aimed to develop pt decision making skills
What does nursing need to develop decision coaching in practice?
Develop competencies through practice, develop supportive environments, regulatory expectations, and outcome research/evidence based practice
