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Benefits of Patient-Centred Care, Health Literacy, and Shared Decision Making

Learn the importance of patient-centred care, health Literacy, and shared Decision making in health care service delivery.

Patient-Centred Care

This focuses on the needs, concerns, beliefs, and goals of the patient such that the patient feels understood, valued, involved in their management, and empowered to gain effective control rather than the responsibility resting with the health professional.1. It emphasizes:

  • Respect for the patient’s opinions, beliefs, needs, and lived experience
  • Sharing of power and responsibility
  • Common understanding of goals
  • Shared decision making
  • Individualising and customising interventions
  • Supporting autonomy and empowerment

Picture of stick figure icon surrounded by different health professionals

There are a number of inter-related elements that contribute to patient-centred care and a basic understanding of these can help clinicians practice in this manner.

Health Literacy

This refers to the degree to which a person can access, understand, evaluate and communicate basic health information and services needed to make appropriate health decisions. Clinicians play an important role in improving the health literacy of their patients and their families/carers. An integral part of this role is high level communication skills by the clinician.

Read this short summary from the Australian Commission on Safety and Quality in Health Care about health literacy and how you can help your patients better understand their health and health care.
https://www.safetyandquality.gov.au/sites/default/files/migrated/Health-literacy-a-summary-for-clinicians.pdf

Of particular note from the summary is the ‘Universal Precautions Approach’ – the approach addresses the problem that you cannot tell which people have low health literacy just by looking at them, and you cannot tell what one person will understand or not understand. The Universal Precautions Approach states that ‘you should assume that your patients may not understand the information you provide and the advice that you give about navigating their way through the health system’. Read more about the approach and what you can do to address health literacy by following the link above.

Shared Decision Making

This is a process whereby patients are supported by clinicians to deliberate about decisions and make choices that are informed by best available evidence about options, potential benefits, and harms and that consider patient values, preferences, and circumstances 2.

Paternalistic (Information and recommendation) 1 way arrow from clinician to patient, Informed decision making (Information) 1 way arrow from clinician to patient, Shared decision making (Information and recommendation) Looping arrow to receiving (Values and preferences) from patient.

Shared decision making has a number of advantages:3

Benefits of shared decision-making. More accurate risk perceptions. Up to 20% choose less invasive surgical options & more conservative treatment. Better patient adherence to therapy. Fewer patients are "passive" in decision-making process. Increased likelihood of receiving care aligned with values. Reduced internal conflict about decisions. Increased knowledge.

Practical Steps in Shared Decision Making

  1. Invite the patient to participate
  2. Present the options
  3. Discuss pros and cons (including the benefits, risks, costs)
  4. Assist the patient to evaluate the options based on their values and preferences
  5. Facilitate deliberation and decision making
  6. Check and clarify the patient’s understanding
  7. Assist with implementing the decision

Patient Decision Aids

These are tools for patients that can be used to help in shared decision-making. The Ottawa Hospital Research Institute has a database of patient decision aids for all different types of conditions. You can go to their website and search their A-Z inventory to find ones that might be suitable for your patients.
https://decisionaid.ohri.ca

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