Training providers in shared decision making for trauma treatment planning.
Bella EtingenJonathan D HessingerHolly A HunleyPublished in: Psychological services (2020)
The U.S. Department of Veterans Affairs (VA)/Department of Defense (DoD) Clinical Practice Guideline (CPG) for the Management of Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder strives to advance the VA's practice of recovery-oriented, evidence-based, patient-centered care (PCC) for veterans with PTSD. A core foundation of PCC is that care is individually tailored to meet the needs and preferences of each patient. Accordingly, the 2017 update to the CPG specifically recommends the use of shared decision making (SDM), an individualized collaborative approach to treatment planning, in the PTSD treatment planning process. Although SDM has been promoted by the CPG throughout the VA and SDM training is being developed, no systemic training was available at the time the guidelines were updated. Additionally, while early research has studied the impact and experience of SDM for the patient, no work has explored provider experiences with SDM for those who work with trauma populations. This project bridges this gap by examining survey data collected 6 months following a formal SDM training to staff and trainees working with veterans who have experienced trauma within a trauma clinic at a large VA hospital. After the training, clinicians understood SDM and were engaging in SDM with their patients. Patients indicated that they were satisfied with and felt like an active participant in the treatment planning process. Clinician assumptions about the SDM process and barriers to SDM shown in previous research were also demonstrated. Implications for future research and practice, such as using decision aids in PTSD treatment planning and targeting clinician beliefs about SDM, are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Keyphrases
- posttraumatic stress disorder
- healthcare
- quality improvement
- end stage renal disease
- primary care
- chronic kidney disease
- palliative care
- newly diagnosed
- dna methylation
- virtual reality
- social support
- case report
- prognostic factors
- emergency department
- peritoneal dialysis
- trauma patients
- mental health
- intensive care unit
- patient reported outcomes
- pain management
- deep learning
- machine learning
- tertiary care
- stress induced
- current status
- cancer therapy
- clinical practice
- big data
- health insurance
- general practice