Exploring experiences associated with aortic stenosis diagnosis, treatment and life impact among middle-aged and older adults

Abstract

Supplemental Digital Content is Available in the Text.

Shared decision making and advance care planning: a systematic literature review and novel decision-making model

“…1 ), step three – information about treatment options, was most widely described and mentioned within twelve studies. Ten studies reported the means by which information was delivered (decision aid [ 27 , 33 , 34 ] or through HCP [ 28 , 29 , 32 , 36 , 37 , 39 , 41 ]) while two studies did not make any clear specifications [ 31 , 40 ]. A second most widely applied SDM step was the exploration of patient wishes and concerns in the decision-making process (step 4)[ 27 , 29 , 32 – 34 , 36 , 37 ].…”

“…Ten studies reported the means by which information was delivered (decision aid [ 27 , 33 , 34 ] or through HCP [ 28 , 29 , 32 , 36 , 37 , 39 , 41 ]) while two studies did not make any clear specifications [ 31 , 40 ]. A second most widely applied SDM step was the exploration of patient wishes and concerns in the decision-making process (step 4)[ 27 , 29 , 32 – 34 , 36 , 37 ]. Description of how the decision was made was described by six studies [ 29 , 34 , 36 , 38 , 39 , 41 ].…”

“…Improvement of quality of life through maintaining independence, ability to perform specific activity and symptom mitigation [ 29 – 32 , 35 , 38 , 40 ] as well as life prolongation [ 31 , 32 , 35 , 37 , 38 , 40 ] were the most often reported patient wishes. Lifelong use of anticoagulants, risk of bleeding or blood clot, valve sound, need for reoperations [ 28 , 34 , 37 ], valve lifespan [ 32 ] or other risks like stroke, blood transfusion, prolonged need for ventilations and possibility of dialysis [ 30 ] were some of the main patient concerns that were reported in the included studies. Becoming a burden to the family or society was also a concern some patients expressed [ 38 ].…”

“…A few studies reported that some patients expressed an explicit wish to make decisions by themselves [ 29 ] or wanted to be involved in the decision-making [ 28 , 31 , 39 ]. One study reported patients making treatment decisions based on their preferences as well as information regarding outcomes like anticoagulation, future interventions and recovery time [ 37 ]. Younger patients assessed themselves as being more engaged in the decision-making than the older patients [ 31 – 33 ].…”

228 Shared decision making and advance care planning: a systematic literature review and novel decision-making model

“…2). 15 studies were included in the final analysis [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] (for description of the included studies, please see supplementary file 2). Cohen's κ was measured to determine the agreement between the two researchers (NR, DD) on 10% of the overall scope, with a substantial agreement at κ = 0.7975.…”