Saying "no" to professional recommendations: client values, beliefs, and evidence-based practice

Area of Science:

• Health behavior
• Patient decision-making
• Evidence-based practice

Background:

• Secondary prevention aims to reduce disease recurrence or progression.
• Patient adherence to recommendations is crucial for effective secondary prevention.
• Understanding patient refusal of recommendations is vital for healthcare providers.

Purpose of the Study:

• To explore why patients decline secondary prevention recommendations.
• To examine the role of client values and beliefs in health decisions.
• To identify strategies for healthcare providers to address patient refusal.

Main Methods:

• Analysis of findings from two qualitative studies.
• Focus on participants who refused secondary prevention recommendations (screening mammograms, latent tuberculosis treatment).
• Examination of patient narratives and decision-making processes.

Main Results:

• Client values and beliefs significantly influence health decisions, even when conflicting with scientific evidence.
• Women demonstrated protective health behaviors despite non-alignment with current evidence.
• Qualitative studies offer valuable insights into patient values and beliefs for evidence-based practice.

Conclusions:

• Integrating client values and beliefs with scientific evidence is essential in evidence-based practice.
• Nurse practitioners are well-positioned to help patients navigate these conflicts.
• Client narratives can facilitate alignment between personal beliefs and scientific recommendations for self-care.