OUTCOMES OF PATIENT EMPOWERMENT

Title

Name

Institution

Outcomes of Patient Empowerment

While treating patients if there is some conflict between the interest of the nurse and the patient then it is the responsibility of the nurse to set aside the interest of his own for the benefit of the patient, but the nurse should make sure that the interests of the patients are not illegal and harmful for the patient. If the nurse has different values than the patient, then ethically they must respect the wishes of the patient. Nurses are committed to their patients and the concerns that they have. Nurses have the moral responsibility of enhancing the dignity and respect of every patient that they serve. They always try to respect the beliefs and opinions of patients even if they differ from their values and the healthcare department policy in such a way that they serve the interest of all but while doing so it should be kept in mind that the patients must not feel attacked that you are going against their values.

There are many situations where patient empowerment creates an ethical dilemma for the healthcare provider. For example, if a patient has severe asthma then it is the nurse duty to tell him about the disadvantages of smoking on his health and also to encourage him about the benefits of healthy eating and healthy lifestyle but even if the patient is not ready to give up on his smoking habit then it can create problems for his health and at such times it is difficult to take care of the patient’s interest so it becomes tough to choose a middle way in such a way that the patient will not feel attacked ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rxhYR8Oy","properties":{"formattedCitation":"(McAllister, Dunn, Payne, Davies, & Todd, 2012)","plainCitation":"(McAllister, Dunn, Payne, Davies, & Todd, 2012)","noteIndex":0},"citationItems":[{"id":832,"uris":["http://zotero.org/users/local/4C6u8dIT/items/QTCQ9DEX"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/QTCQ9DEX"],"itemData":{"id":832,"type":"article-journal","title":"Patient empowerment: The need to consider it as a measurable patient-reported outcome for chronic conditions","container-title":"BMC Health Services Research","page":"157","volume":"12","source":"PubMed Central","abstract":"Background\nHealth policy in the UK and elsewhere is prioritising patient empowerment and patient evaluations of healthcare. Patient reported outcome measures now take centre-stage in implementing strategies to increase patient empowerment. This article argues for consideration of patient empowerment itself as a directly measurable patient reported outcome for chronic conditions, highlights some issues in adopting this approach, and outlines a research agenda to enable healthcare evaluation on the basis of patient empowerment.\n\nDiscussion\nPatient empowerment is not a well-defined construct. A range of condition-specific and generic patient empowerment questionnaires have been developed; each captures a different construct e.g. personal control, self-efficacy/self-mastery, and each is informed by a different implicit or explicit theoretical framework. This makes it currently problematic to conduct comparative evaluations of healthcare services on the basis of patient empowerment. A case study (clinical genetics) is used to (1) illustrate that patient empowerment can be a valued healthcare outcome, even if patients do not obtain health status benefits, (2) provide a rationale for conducting work necessary to tighten up the patient empowerment construct (3) provide an exemplar to inform design of interventions to increase patient empowerment in chronic disease. Such initiatives could be evaluated on the basis of measurable changes in patient empowerment, if the construct were properly operationalised as a patient reported outcome measure. To facilitate this, research is needed to develop an appropriate and widely applicable generic theoretical framework of patient empowerment to inform (re)development of a generic measure. This research should include developing consensus between patients, clinicians and policymakers about the content and boundaries of the construct before operationalisation. This article also considers a number of issues for society and for healthcare providers raised by adopting the patient empowerment paradigm.\n\nSummary\nHealthcare policy is driving the need to consider patient empowerment as a measurable patient outcome from healthcare services. Research is needed to (1) tighten up the construct (2) develop consensus about what is important to include (3) (re)develop a generic measure of patient empowerment for use in evaluating healthcare (4) understand if/how people make trade-offs between empowerment and gain in health status.","DOI":"10.1186/1472-6963-12-157","ISSN":"1472-6963","note":"PMID: 22694747\nPMCID: PMC3457855","shortTitle":"Patient empowerment","journalAbbreviation":"BMC Health Serv Res","author":[{"family":"McAllister","given":"Marion"},{"family":"Dunn","given":"Graham"},{"family":"Payne","given":"Katherine"},{"family":"Davies","given":"Linda"},{"family":"Todd","given":"Chris"}],"issued":{"date-parts":[["2012",6,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (McAllister, Dunn, Payne, Davies, & Todd, 2012).

Although it is important that patients must receive the required care to improve their health and should have the freedom to make their personal choices if those are not harmful for others so there is an ethical consensus that capable individuals can accept or refuse treatment. However, for incompetent patients who refuse to get treatment, interventions must be made based on their previous listed wishes, for instance, their help for a proxy and on their real best wishes or even the combination of both. Therefore, in such situation capacity assessment plays an important role because by using this the nurses will be able to evaluate the competency of the patient and to decide that what they should do when a patient refuses any positive treatment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pB4iM4RV","properties":{"formattedCitation":"(Hurst, 2004)","plainCitation":"(Hurst, 2004)","noteIndex":0},"citationItems":[{"id":835,"uris":["http://zotero.org/users/local/4C6u8dIT/items/JGHU8V73"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/JGHU8V73"],"itemData":{"id":835,"type":"article-journal","title":"When patients refuse assessment of decision-making capacity: how should clinicians respond?","container-title":"Archives of Internal Medicine","page":"1757-1760","volume":"164","issue":"16","source":"PubMed","abstract":"When patients refuse beneficial treatment, the assessment of decision-making capacity plays a key role in determining the best course of action. However, situations in which patients refuse to explain their reasons occur. This can make an assessment of capacity impossible. In such cases, clinicians find themselves in difficult situations without clear ethical guidance. Refusal to give reasons for refusing beneficial treatment has been seen as pointing to the absence of decision-making capacity. However, the reasons given for this are either unsatisfactory or insufficient to eliminate cases of genuine uncertainty. This article argues that although it cannot be concluded that such patients are incompetent, there are reasons to treat them as if they were. The basis of this possibility, however, points to several obligations for clinicians before such a situation can be said to exist.","DOI":"10.1001/archinte.164.16.1757","ISSN":"0003-9926","note":"PMID: 15364668","shortTitle":"When patients refuse assessment of decision-making capacity","journalAbbreviation":"Arch. Intern. Med.","language":"eng","author":[{"family":"Hurst","given":"Samia A."}],"issued":{"date-parts":[["2004",9,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hurst, 2004).

Patient empowerment is not always the answer, and sometimes it creates hurdles in the treatment when the patient unnecessarily refuses to get treatment at that time just because of not offending the patient the healthcare providers are bound to whatever the patient says, and it becomes difficult to provide the required care. So there must be a limit to patient empowerment because in the state of disease they cannot make wise decisions so by limiting it the doctors can treat them efficiently.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Hurst, S. A. (2004). When patients refuse assessment of decision-making capacity: how should clinicians respond? Archives of Internal Medicine, 164(16), 1757–1760. https://doi.org/10.1001/archinte.164.16.1757

McAllister, M., Dunn, G., Payne, K., Davies, L., & Todd, C. (2012). Patient empowerment: The need to consider it as a measurable patient-reported outcome for chronic conditions. BMC Health Services Research, 12, 157. https://doi.org/10.1186/1472-6963-12-157