This is the conversation that happens between a patient and their healthcare professional to reach a healthcare choice together. This conversation needs patients and professionals to understand what is important to the other person when choosing a test or treatment.
It is the role of the healthcare professional to collaborate with the patient and actively encourage him/her to be involved in the decision making, enabling them to make an informed choice about whether or not they agree to having the particular test done or which test they have done, if there are a few possibilities.
The conversation between the doctor/nurse and patient is core to shared decision-making based on the individual’s priorities and preferences, fears and concerns. The BMJ: Time to deliver patient-centred care: BMJ 2015;350:h530
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Pulse point
The overarching aim of patient-centred care is to ensure the patient is an active participant in making decisions about their investigations, treatment and care.
After explaining the risks and benefits of a particular investigation, such as, an angiogram, to the patient, they may feel that they are not willing to accept any risk of stroke and decline to have the angiogram done, even though you believe that they should go ahead with the test because their symptoms warrant it. Although we can explore the patient’s fears further, in the end, we have to accept the patient’s wishes.
Scene 1:
- Health care professional says: I think we need to do some tests to find out the cause of your symptoms?
- Patient thinks:
- What does the test involve?
- How will this help me?
- What are the risks?
Scene 2
- HCP says: I will explain all about the test to you and the risks and benefits. It is your decision whether we go ahead or not
- Patient thinks:
- Will there be any pain or discomfort?
- Do I have any other options?
- Will I need to go into hospital for this or can I have it done at the GP surgery?
- If the doctor finds something wrong, is she going to be able to do anything about it?
- The doctor / nurse will have to consider whether they will be able to offer the patient any treatment on the basis of the result or is it just going to provide a diagnostic label?
Scene 3
- HCP says: Do you have any concerns about the test or is there anything you wish to ask?
- Patient thinks:
- When will I get the results?
- How soon will it be done?
- This sounds like the same thing that Jim at work had done and he’s never got back to work! I am going to ask her about that.
- Offer the patient written material or sign-post to e.g. a video for them to learn more about the investigation, before making their decision if unsure about it.
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Page last reviewed: 30 Jul 2020