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The Voices of Patients: Do They Really Matter?

Yuan, Changrong PhD, RN, FAAN

doi: 10.1097/NCC.0000000000000470
DEPARTMENTS: Guest Editorial

Editorial Board Member, Cancer Nursing School of Nursing Second Military Medical University Shanghai, China.

The author has no funding or conflicts of interest to disclose.

Correspondence: Changrong Yuan, PhD, School of Nursing, Second Military Medical University, 800 Xiangying Rd, Shanghai 200433, China (

Accepted for publication December 5, 2016.

Rescuing the health and caring for patients can take a long time because both involve physical, mental, and social rehabilitation challenges. Self-management is an important, recognized component of this care. In recent years, including patients’ voices in treatment considerations has increasingly become a part of healthcare practice through clinical data gathering, diagnosis, treatment, and choice of therapeutic interventions.1 By so including the patients’ voices, clinicians can better understand patients’ feelings and perceptions. As a result, clinician-patient communication and patient satisfaction can be improved. Research results have shown that we may find very positive consequences by only listening to patients. Modern nursing should transform from “being there” to “being with,” and we as clinicians should treat patients as we want to be treated. It is our responsibility to listen as the basis of implementing care and comfort.

Voices of patients can be active or passive. Active voice usually centers on patients’ needs, worries, and requirements related to the disease itself. Passive voice usually refers to health-related information collected from patients for specific purposes, such as assessing treatment adverse effects and monitoring physical signs. Although the importance of the patients’ voices is in our awareness, how to accurately interpret and bring that voice into clinical practice is not well developed. For example, the trustworthiness of the patients’ voice in some circumstances is not established because patients may prioritize minimizing the burden on their loved ones over their own preferences and values.2 How we handle this challenge will affect clinical workflow, no matter how we do this.

Listening to the voices of patients does not mean replacing the professional judgment of clinicians—the patient voices are an important supplement and help care to be more humanistic. Three barriers restrict integrating patient voices into clinical care: (1) expert query—physicians are not used to including the patient voices in surgical or other treatment interventions. In some countries, physicians prefer to rely on their experience, physical examinations, and imaging tests. Because of the nearly infinite reasons for patients’ perceived discomforts, all clinicians should be careful to make care decisions so as not to break the trust relationship between them. (2) Patients’ lower engagement in sharing honest preferences can cast doubt on their understanding of their condition. Patients may not be ready to report at times or may not be able to confidently report. This reticence does not mean patients are not responsible for their health, only that they are unsure how to describe their condition and may choose to hide feelings. (3) Standard evidence-based approaches about how to incorporate the voices of patients are absent or incomplete in clinical practice, leaving clinicians without rules or guidance about how to include patient voices in care.

One effective practice to solicit the patient voice is to use patient-reported outcome measures3 using attractive electronic or gamelike methods. Encouraging physicians and nurses to listen to patients is essential as is supporting patients to report and express themselves. The voices of the patient matter to all of us.

My best to you,

Changrong Yuan, PhD, RN, FAAN

Editorial Board Member, Cancer Nursing

School of Nursing

Second Military Medical University

Shanghai, China

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1. Jagosh J, Donald Boudreau J, Steinert Y, Macdonald ME, Ingram L. The importance of physician listening from the patients’ perspective: enhancing diagnosis, healing, and the doctor-patient relationship. Patient Educ Couns. 2011;85(3):369–374.
2. Kelly B, Rid A, Wendler D. Systematic review: individuals’ goals for surrogate decision-making. J Am Geriatr Soc. 2012;60(5):884–895.
3. Coons SJ, Gwaltney CJ, Hays RD, et al. Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO Good Research Practices Task Force report. Value Health. 2009;12(4):419–429.
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