Aim To describe young adult patients’ experiences of living with a mechanical circulatory support (MSC) as a bridge to heart transplantation and impact of self‐efficacy. Design A qualitative and explorative interview study. Methods Eight interviews with adult participants were conducted and analysed using the phenomenological hermeneutical method. Results An overall theme, “Navigating from helplessness to feeling strong in the new reality,” and three themes were identified: “Feeling homeless in a changed reality” describes the experience of suddenly falling ill and the loneliness caused by the disease; “Finding my own inner resources” shows that the interviewees found the strength to fight for their lives and began to regain control of their situation; and “Adapting to my new reality” describes the importance of finding strength from others and being able to see MCS as a friend providing respite from the disease. Self‐efficacy beliefs play a significant role in the process that the participants went through.
Background Aortic stenosis is the most common valvular disease, and its prevalence is increasing due to the ageing population. Transcatheter aortic valve replacement (TAVR) is the recommended method when treating frail, older patients. Knowledge of what motivates older patients to undergo TAVR is important, in order to meet patients' expectations. Objective The study aimed to explore the meaning of older patients' motivation to undergo TAVR. Design and Methods The design was a qualitative study, analysed using a phenomenological hermeneutic approach. In‐depth, semi‐structured interviews with open‐ended questions were conducted. Participants were selected from a specialist cardiology clinic in Sweden. Eighteen patients, six women and twelve men, aged 66–92, were recruited. Results The analysis showed that patients who had agreed to undergo TAVR were deeply affected by their body's failure. Before the TAVR procedure, the participants were limited in their daily activities and experienced that their life was on hold. They experienced that they were barely existing. They were aware of their life‐threatening condition and were forced to confront death. Yet despite an advanced age, they still had considerable zest for life. It was very important to them to remain independent in everyday life, and fear of becoming dependent had a strong impact on their motivations for undergoing TAVR. Conclusion Older patients' motivations to undergo TAVR are strongly influenced by their fear of being dependent on others and their zest for life. Health care professionals need to support these patients in setting realistic and personalised goals. Implication for practice Person‐centered care actions could facilitate patients' involvement in the decision about TAVR and strenghten patients' beliefs in their own capabilities, before and after TAVR.
Background Atrial fibrillation (AF) is the most common heart rhythm disorder, increases the risk for stroke and heart failure, and commonly impairs health related quality of life. Increasing evidence shows the causative role of several risk-factors and that aggressive lifestyle interventions might reduce AF and its impact. The size of the problem and how to provide optimal multi-disciplinary management is less well known. Purpose To screen for potentially amenable risk factors and describe how patients rate their symptom burden, well-being and expectations of future treatment. Methods The risk profile, symptom burden, well-being and expectations of future treatment were identified in 352 consecutive patients referred for possible cardioversion and visiting a specialist nurse at an AF outpatient clinic. Various questionnaires and instruments were used in addition to medical history, ECG recording, and height, weight, BMI calculation and blood pressure (BP) measurement. Results Altogether 69% had 1–5 possibly modifiable risk factors, 50% were overweight or obese, 39% had a BP >140/90 mmHg, 28% symptoms suggesting obstructive sleep apnoea and 25% reporterd no physical exercise. Respiratory distress during exertion was the most common symptom. Most patients had high expectations for their upcoming AF treatment, but men expected a full recovery more often than women (p=0.01). About 28% worried about their future health and reduced survival due to their AF. Conclusion Most of the patients with paroxysmal/persistent AF have risk factors suitable for life styles interventions. Many patients experience limitations in daily life, anxiety about their AF and worry about their future health and survival. Women and men also have different expectations of future care and treatment for recurrent AF. Funding Acknowledgement Type of funding source: None
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