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      Resultados de aprendizaje de las competencias enfermeras relacionadas con la toma de decisiones en el contexto de atención al paciente crónico con necesidades complejas Translated title: Learning outcomes of nursing competencies relared to decision making in the context of care for chronic patients with complex needs

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          Abstract

          RESUMEN Referencia del documento de práctica clínica basada en la evidencia: Prat Martínez M, et al. Resultados de aprendizaje de las competencias enfermeras relacionadas con la toma de decisiones en el contexto de atención al paciente crónico con necesidades complejas. Educ Med. 2019. https://doi.org/10.1016/j.edumed.2019.10.014

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          Shared Decision Making: A Model for Clinical Practice

          Glyn Elwyn, Dominick Frosch, Richard Thomson … (2012)
          The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk. The model has three steps: a) introducing choice, b) describing options, often by integrating the use of patient decision support, and c) helping patients explore preferences and make decisions. This model rests on supporting a process of deliberation, and on understanding that decisions should be influenced by exploring and respecting “what matters most” to patients as individuals, and that this exploration in turn depends on them developing informed preferences.
          Article 0 comments Cited 801 times – based on 0 reviews     Review now
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            Do people want to be autonomous patients? Preferred roles in treatment decision-making in several patient populations.

            Raisa B Deber, Nancy Kraetschmer, Sara Urowitz … (2007)
            What role do people want to play in treatment decision-making (DM)? Examine the role patients indicate they would prefer in making treatment decisions across multiple clinical settings in Ontario, Canada. Secondary analysis of a series of survey/interview-based studies measuring preferred role, conducted in 12 different populations. Respondents were outpatients, largely but not entirely attending outpatient clinics in large teaching hospitals in urban settings in the Province of Ontario, Canada. The subgroups and sample sizes were: breast cancer (202), prostate disease (202), fractures (202), continence (46), orthopaedic (111), rheumatology (56), multiple sclerosis (22), HIV/AIDS (431), infertility (454), benign prostatic hyperplasia (678) and cardiac disease (300), plus 50 healthy nursing students (for scale validation). All studies categorized preferred role using the Problem-Solving Decision-Making (PSDM) scale with one or both of the Current Health condition and Chest Pain vignettes. Few respondents preferred an autonomous role (1.2% for the current health condition vignette and 0.7% for the chest pain vignette); most preferred shared DM (77.8% current health condition; 65.1% chest pain) or a passive role (20.3% current health condition; 34.1% chest pain). Familiarity with a clinical condition increases desire for a shared (as opposed to passive) role. Preferences for passive vs. shared roles varied across settings; older and less educated individuals were most likely to prefer passive roles. Despite consumerist rhetoric among some bioethicists, very few respondents wish an autonomous role. Most wish to share DM with their providers.
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              La atención al paciente crónico en situación de complejidad: el reto de construir un escenario de atención integrada

              Juan Contel, Blanca Muntané, Lourdes Camp (2012)
              El envejecimiento de la población y el aumento de personas con enfermedades crónicas constituye un escenario que plantea importantes retos en la manera como organizar y prestar los servicios para este grupo de población. Existen ya experiencias y evidencia que nos ayudan a repensar qué aspectos claves deberían ser tenidos en cuenta para diseñar un modelo sanitario sensible y orientado a este nuevo paradigma. El enfoque clínico asistencial por sí mismo es importante pero a su vez limitado; se requiere de un abordaje multidimensional donde se incorporen elementos diferentes como verdaderas palancas de cambio: qué aportación pueden realizar los sistemas de información, qué objetivos deben asignarse de manera transversal a diferentes organizaciones y profesionales, qué competencias clínicas y relacionales deberían contemplarse en los planes de formación y desarrollo de competencias o cómo se debe financiar la provisión. Además, sólo interactuando con varios de estos elementos se podrá llevar a cabo un cambio significativo en la atención a los pacientes crónicos, especialmente a aquellos que están en situación de mayor complejidad y vulnerabilidad.
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                Author and article information

                Journal
                Journal ID (publisher-id): ene
                Title: Ene
                Abbreviated Title: Ene.
                Publisher: Martín Rodríguez Álvaro (Santa Cruz de La Palma, La Palma, Spain )
                ISSN (Electronic): 1988-348X
                Publication date (Print and electronic): 2021
                Volume: 15
                Issue: 1
                Electronic Location Identifier: 1240
                Affiliations
                [1] Zaragoza orgnameHospital Universitario Miguel Servet orgdiv1Instituto de Investigación Sanitaria Aragón España
                Article
                Publisher ID: S1988-348X2021000100012 Publisher ID: S1988-348X(21)01500100012
                SO-VID: 24995feb-a052-45af-aa56-a41c31ed6a3b
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 5, Pages: 0
                Product

                SciELO Spain

                Categories
                Subject: Resúmenes de Evidencia

                Keywords: quality of care,toma de decisiones,nursing,chronic diseases,professional competence,calidad asistencial,competencia profesional,enfermería,enfermedades crónicas,decision making
                Data availability:
                Keywords: quality of care, toma de decisiones, nursing, chronic diseases, professional competence, calidad asistencial, competencia profesional, enfermería, enfermedades crónicas, decision making

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