solved Discussion Patient Preferences and Decision Making A woman, 33 years

Discussion
Patient Preferences and Decision Making
A woman, 33 years old, came into the emergency department with what she termed a “terrible headache that comes and goes.” History was taken, showing that she had been involved in an accident a few months before but had not suffered any major injuries. She also said her vision gets blurry, and part of her arm feels numb with a tingling sensation during the severe headaches. The patient wanted to know what is causing the headaches, so we discussed the options. I informed her that there is a possibility she had suffered a traumatic brain injury and may require a head computed tomography scan. However, the headaches may be related to other illnesses, and a CT scan might not help. I discussed with the patient about the procedure of CT scan, the benefits, and the risk factors involved if she gets or does not get one. For example, I educated her on the possibility of ruling out serious brain injury issues like blood clots but also noted that CT scans are expensive, and they may be allergic to a dye used. On the other hand, they could go home with medication and make lifestyle changes that manage the headaches, which is cheaper and offers time to assess severity after treatment. The patient strongly felt that she needed a CT scan to ensure she did not injure her brain in the accident. 
Involving the patient in assessing treatment options gives them control and autonomy (Austin et al., 2020; Brabers et al., 2017). The process also reflects how much they trust the providers to have their best interest at heart (Nuwagaba et al., 2021). Knowing what is entailed in either treatment option, the patient felt that money was not a problem so long as she gets to know the cause of the headaches. We used the “headaches; should I have imaging tests or not?” decision tool developed by Healthwise (Healthwise Staff, 2020). In such cases, this tool provides a 5-step decision process; getting the facts, comparing options, patient feelings, decision, quiz, and summary. In the future, this tool will be beneficial to patients with any form of traumatic brain injury, wondering whether imaging tests are the best for them.
References
Austin, E. E., Blakely, B., Tufanaru, C., Selwood, A., Braithwaite, J., & Clay-Williams, R. (2020). Strategies to measure and improve emergency department performance: A scoping review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(55). https://doi.org/10.1186/s13049-020-00749-2
Brabers, A. E., Rademakers, J. J., Groenewegen, P. P., Van Dijk, L., & De Jong, J. D. (2017). What role does health literacy play in patients’ involvement in medical decision-making?. PloS one, 12(3), e0173316. https://doi.org/10.1371/journal.pone.0173316
Healthwise Staff. (2020). Headaches: Should I have imaging tests to find out what’s causing my headaches? Healthwise. https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=aa162506
Nuwagaba, J., Olum, R., Bananyiza, A., Wekha, G., Rutayisire, M., Agaba, K. K., Chekwech, G., Nabukalu, J., Nanyonjo, G. G., Namagembe, R., Nantongo, S., Lubwama, M., Besigye, I., & Kiguli, S. (2021). Patients’ involvement in decision-making during healthcare in a developing country: A cross-sectional study. Patient Preference and Adherence, 15, 1133-1140. https://doi.org/10.2147/ppa.s302784