Janet Jull, Queen’s University, Ontario; Dawn Stacey, University of Ottawa / University of Ottawa, and Sascha KÃ¶pke, University of Cologne
The COVID-19 pandemic sparked unprecedented interest in science as people all over the world were faced with decisions that affected their health. These included decisions such as compliance with public health protection measures, immunization and access to health services.
All of this has happened in rapidly changing uncertain environments. Events related to the COVID-19 pandemic have highlighted the importance of what constitutes credible information or evidence (research-based information) and how evidence is communicated and used to make decisions. At the start of the pandemic, little was known about COVID-19, and making health decisions was a challenge.
The ongoing pandemic has given rise to what is characterized as an “infodemic” due to the large amount of information available, including the rapid spread of disinformation or false science reporting. From media reporting in a 24/7 news cycle to reliance on social media influencers, in many cases with strong editorial bias, the media environment information is confusing and difficult to navigate.
The sheer amount of information can pose daunting challenges for those seeking information to make informed healthcare decisions. For example, it has been found that misinformation negatively affects people’s willingness to get vaccinated and can lead to risky behavior.
Making decisions that impact health was an almost universal experience during the pandemic – it affected everyone. Often, these decisions were made without the support of health care providers. Our health systems have been challenged to better help people make health care decisions, for example by exploring options for determining how to support informed, values-based COVID-19 vaccination decisions.
We are members of an international interdisciplinary team of patient partners, healthcare providers, educators and researchers who include patient perspectives in a leadership capacity. We have sought to understand and advance an approach to preparing patients for health decisions called shared decision making.
Support for people in taking charge of their health
âShared decision makingâ occurs when a person with a health problem works together with their health care providers to make decisions about chronic disease screening, treatment or management. Shared decision making supports person-centered care and helps people take an active role in their health care decisions.
Standard care provides patients with evidence-based information about health choices. However, with shared decision making, a person’s individual preferences, beliefs and values ââare factored into health decision making, as well as clinical evidence.
Importantly, shared decision making is a process that helps people understand the risks and benefits of different options through discussion and information sharing with their healthcare providers.
In fact, shared decision making has been called âthe pinnacleâ of person-centered care. A key feature of shared decision making is the exploration of patient values ââand priorities and it can be facilitated using evidence-based decision support tools and approaches.
Patient decision aids and decision coaching help people take an active role in decision making. Decision aids include booklets, videos, and online tools that clarify the decision, provide options, pros and cons, and help people clarify what matters to them.
They can be used by patients alone or in consultation with a health care provider. They have been shown to help people feel better informed, better informed and clearer about their values. In addition, people probably have a more active role in decision-making and a more precise perception of risks.
Our team believed it was important to determine the unique contribution of decision coaching, an intervention with great potential to help people prepare for healthcare decisions. Decision coaching is delivered by qualified healthcare providers to support people facing decisions, with or without the use of an evidence-based tool (such as a decision support tool for patients) .
We conducted a systematic review to assess the effects of decision coaching. The review included 28 studies that covered a range of medical conditions with treatment and screening decisions.
While more research is needed on many outcomes, we have found that decision coaching can improve participants’ knowledge (related to their condition, options, outcomes, personal values, preferences) when used with factual information. Our results do not indicate any significant adverse effects (eg, decision regret, anxiety) with the use of decision coaching. https://www.youtube.com/embed/egJlW4vkb1Y?wmode=transparent&start=0
Although we began our systematic review before the COVID-19 pandemic, our exploration of decision coaching is even more relevant given the decision-making demands of the pandemic and the difficulty of decisions that accompany it.
Experiences with the COVID-19 pandemic have shown that, in complex and rapidly changing healthcare environments, strategies that keep healthcare focused on the person are essential. Shared decision-making tools and approaches, ideally using decision support tools and decision coaching, can help shape people-centered health services that put people first and uphold the principle of ‘no. decision about me, without me â. To make the best health decisions for themselves and their families, people need the support and opportunities to work with trusted health care providers.
Maureen Smith, President of the Cochrane Consumer Network Executive, is co-author of this article.
Janet Jull, Assistant Professor, School of Rehabilitation Therapy, Queen’s University, Ontario; Dawn Stacey, Full Professor, School of Nursing, University of Ottawa / University of Ottawa, and Sascha KÃ¶pke, Professor, Institute of Nursing, University of Cologne
This article is republished from The Conversation under a Creative Commons license. Read the original article.