4.6 Article

Patients' experiences from symptom onset to initial treatment for atrial fibrillation

期刊

JOURNAL OF CLINICAL NURSING
卷 24, 期 5-6, 页码 786-796

出版社

WILEY
DOI: 10.1111/jocn.12708

关键词

atrial fibrillation; patient education; patient experiences; patient perspectives; patient-provider interaction; qualitative content analysis

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资金

  1. New Investigator Seed Grant from the Midwest Nursing Research Society

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Aims and objectivesTo describe patients' experiences from symptom onset to initial treatment for atrial fibrillation. BackgroundThe estimated number of individuals with atrial fibrillation globally in 2010 was 335million. World-wide, each year, new cases of atrial fibrillation approach 5million, and prevalence will increase 25-fold by 2050. As a result, clinicians worldwide will treat a growing number of patients with atrial fibrillation. Early intervention to promote atrial fibrillation self-management is critical to reduce associated complications of stroke and heart failure. Greater understanding of patients' experiences from symptom onset to initial treatment for atrial fibrillation is needed to guide development of interventions to promote early effective self-management. DesignA descriptive qualitative design was used. MethodsTwenty females and 21 males at an academic medical centre were interviewed using open-ended questions to explore their experiences from symptom onset to initial treatment for atrial fibrillation. Data were analysed using qualitative content analysis. ResultsParticipants' mean age was 643 (SD=101) years. Four themes were identified: (1) misinterpreting symptoms; (2) discovering the meaning of atrial fibrillation; (3) facing fears, uncertainty, and moving to acceptance; and (4) receiving validation and reassurance. Participants lacked knowledge of atrial fibrillation and took cues from providers' responses to appraise symptoms and diagnosis. Fear and uncertainty were reduced when providers initiated prompt treatment and took time to explain atrial fibrillation. Patients appreciated receiving clear information about atrial fibrillation, were engaged in learning, and motivated to participate in their care. ConclusionsProviders played a critical role in helping patients to develop an accurate understanding of atrial fibrillation, to cope with the new diagnosis, and motivated them to engage in effective self-management. Relevance to clinical practiceInsight into participant experiences from symptom onset to initial treatment for atrial fibrillation may inform development of interventions to promote effective atrial fibrillation self-management.

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