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Ottawa Hospital Research Institute


Web resource, Ottawa, Ontario, Canada: Ottawa Hospital Research Institute, 2015, free.


REVIEW: I recently stumbled upon this fantastic website and knew I had to share it with JCN readers. As nurses, we know it can be quite difficult for patients and families to decide what the best screening or treatment options are in healthcare situations, especially crises. The Patient Decision Aids website is the go-to resource for offering support to help patients determine their best choice for just about any healthcare diagnosis. A recent Cochrane Library review explains about decision aids for patients:

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Decision aids can be used when there is more than one reasonable option, when no option has a clear advantage in terms of health outcomes, and when each option has benefits and harms that patients may value differently. Decision aids may be pamphlets, videos, or web-based tools. They make the decision explicit, describe the options available, and help people to understand these options, as well as their possible benefits and harms. This helps patients to consider the options from a personal view (e.g., how important the possible benefits and harms are to them) and helps them to participate with their health practitioner in making a decision. (Stacey et al., 2014)


How did Patient Decision Aids come about? In 1989, a chapter titled "Decisional Conflict" in the first edition of Nursing Diagnosis and Intervention: Planning for Patient Care (McFarland & McFarlane, Mosby) discussed "clinical strategies [to use] when a patient presents with decisional needs, such as uncertainty about a course of action" (Patient Decision Aids [PDA], 2015a). Moving forward, a team of nurses at the University of Ottawa, Canada, started a Patient Decision Aids Research Group and began developing evidence-based, decision-making tools for patients to use for screening and healthcare choices. Today, researchers worldwide are involved in the project, and hundreds of validated decision tools for conditions ranging from "Acne" to "Weight Control" are provided free to anyone visiting the site. Aids for cosmetic to life-threatening health decisions are offered. In addition to tools for specific health conditions, "Ottawa Personal Decision Guides" for one or two people are provided for any health-related or social decision that "help people identify their decision-making needs, plan the next steps, track their progress, and share their views about the decision" (PDA, 2015b). The Guides are available in multiple languages.


Beyond providing tools for screening and treatment for health conditions, resources for "decision coaching" are available. A Decision Coach is "a trained healthcare professional, who is non-directive and provides support that aims to develop patients' skills in: thinking about the options; preparing for discussing the decision in a consultation with their practitioner; and implementing the chosen option" (PDA, 2015c). Training for coaching involves learning about decision-coaching as an intervention to prepare patients to discuss options with their practitioner, and may or may not include the use of decision support tools. An in-depth "Development Toolkit" is offered for anyone wanting to follow the Ottawa patient decision aid development process to create a new tool to place on the website.


The mission of Patient Decision Aids is "To explore better ways to help patients make 'tough' healthcare decisions that may have: multiple options; uncertain outcomes; benefits and harms that people value differently" and "To explore better ways to help practitioners support patients making 'tough' healthcare decisions." Every decision aid is based on systematic investigation to "understand the decisional needs of patients and their practitioners; design and evaluate decision aids and coaching interventions; design and evaluate strategies for implementing decision support services; and develop and evaluate training programs to improve the quality of practitioners' decision support" (PDA, 2015a).


Whether you are a nursing student, staff nurse, educator, faith community nurse, advanced practice nurse, or simply a supportive friend or family member, Patient Decision Aids is one of the most invaluable tools you can use as you care for those facing healthcare decisions.-KSS


Patient Decision Aids. (2015a). Mission & History. Retrieved from[Context Link]


Patient Decision Aids. (2015b). Ottawa personal decision guides. Retrieved from[Context Link]


Patient Decision Aids. (2015c). Decision coaching. Retrieved from[Context Link]


Stacey D., Legare F., Col N. F., Bennett C. L., Barry M. J., Eden K. B., ..., Wu J. (2014). Decision aids for people facing health treatment or screening decisions. The Cochrane Library. Retrieved from[Context Link]




The Unexpected Blessing of Thankfulness

By Joshua Choonmin Kang


192 pp., Downers Grove, IL: InterVarsity Press, 2015, $16.00, paperback; also available as eBook. (NCF members receive 30% off all InterVarsity Press books!)


REVIEW: This title caught my attention as I journey toward a greater attitude of gratitude. The unexpected pleasure lies in the depth of these writings. This isn't a let's be happy about everything approach. Rather, Kang challenges readers to accept hard circumstances and look for "opportunities for God to perform his great work" (p. 29). Brokenness, humility, isolation, deficiency, thorns-in these difficulties we can see "God's sovereignty in the midst of suffering" (p. 9).

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In six well-written parts, based on personal experiences, Kang discusses: A Source of Grace, What We Are Grateful For, The Power of Gratitude, The Spiritual Gifts of Gratitude, and The Path to Gratitude. Kang notes in the first chapter that he had experienced a very difficult season of life. "Yet throughout, I yearned for gratitude. I wanted to be grateful and for that gratitude to sustain me" (p. 9). The depth of his thoughts leaves me thinking that yearning was fulfilled.


This book may well become a classic. The 52 brief readings provide devotional thoughts. I savored it slowly, one chapter daily, taking time to reflect; I plan to return to it regularly. I want to grow in gratefulness. "Gratitude affords the opportunity for problems to become treasures" (p. 30).-Cathy Walker, JCN Associate Editor, Madison, WI.


Going Deeper

Going Deeper helps you dig deeper into JCN content, offering ideas for personal or group study with others-great for Nurses Christian Fellowship groups!


* Autism Spectrum Awareness: Read Farley, pp. 212-218.


1. Autism Spectrum Disorder reflects a condition that has a range of severity of symptoms in two core domains. What are those domains?


2. How many levels of severity are assigned to the disorder?


3. Discuss the author's statement, "It is important that diagnoses should be used to make recommendations for interventions rather than pin a specific identification on a child."


4. Describe the concept of othering as noted in the article. How have you seen this in your practice or religious setting?


5. What skills or compassion might you have to come alongside a family of a child with Autism Spectrum Disorder?


6. Consider the following Scripture: Psalm 139:13-16. Wrestle with the concept of being wonderfully made, yet having a physical disorder.


* Global Volunteer Preparation: Read Carey et al., pp. 242-249.


1. What are some steps needed to adequately prepare to serve in healthcare overseas?


2. In what ways can a lack of preparation hurt more than help in a cross-cultural situation?


3. Upon what do sustainable health outcomes depend?


4. List five principles that acknowledge and guide the critical component of evaluating collaboration.


5. Read and discuss Matthew 28:18-20 in light of this article.


* Spiritual Care Taught Via Simulation: Read Blesch, pp. 232-235.


1. What spiritual assessment tools are available to nurses?


2. To what degree was spiritual care taught in your nursing education experience? How comfortable or uncomfortable are you in addressing spiritual care needs?


3. The author writes, "Nursing students who consider their own spiritual beliefs prior to entering the clinical setting will be better prepared to address client spiritual needs." Do you agree or disagree? Why?