Living With Atrial Fibrillation

Abstract

Themes were identified that reveal experiences of living with recurrent symptomatic AF over time and how AF may diminish QOL. Themes included (1) finding the meaning of symptoms, (2) feeling uninformed and unsupported, (3) turning points, (4) steering clear of AF, (5) managing unpredictable and function limiting symptoms, (6) emotional distress, and (7) accommodation to AF tempered with hope for a cure. Participants experienced delays in diagnosis and minimization of their concerns by clinicians and others and did not receive counseling regarding the nature of AF and self-management. Strategies to manage AF and its symptoms were learned through trial and error and were transiently effective. Support for coping with the emotional burden of AF was lacking. Interventions to improve recognition of AF symptoms and promote prompt evaluation and treatment are needed. Psychoeducational programs to teach patients and families about the nature of AF, guide self-management, and address the emotional burden of AF need to be developed and tested.

Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy: A qualitative meta-synthesis

“…Only McCabe et al [19] explored patients' pre-diagnosis experiences. They found that some were diagnosed accurately and quickly, whilst for others the process was slow because arrhythmia is difficult to document on an ECG and AF symptoms are not always clear which led to some patients being misdiagnosed with stress.…”

“…[19] "The doctor came in and said: "The good news is you're not crazy. The bad news is there is something wrong."…”

“…(Patient 16, final treatment aspirin) [27] There are other issues related to lifestyle which resulted in refusal of, or a negative perception of, warfarin: the need for regular blood tests to monitor anticoagulation control, the amount of time it takes to do the tests, abstinence of alcohol, and an ever increasing amount of tablets. [19,21,23,24,28,29] "I've had one patient who has refused to go on warfarin . .…”

“…It may be fixed versus going on feeling yucky and not getting an answer." (Patient) [19] Participants from three studies [19,21,22] Indeed, GPs were found to have different communication styles with varying rates of success. Some GPs preferred discussing statistics about risks associated with warfarin to help the patient reach a decision about warfarin uptake, while others preferred to avoid probabilities and statistics and instead offered a more doctor-led style.…”

Quality of Life - Exemplified through Patients Living with Atrial Fibrillation

“…Five of the papers used the WHO definition [3,31,32,38,60], and multidimensional aspects were also included in their arguments. The paper written by McCabe et al [73] examplified the importance of including qualitative descriptive perspectives as well, when working with the concept of QOL. Five of the papers called for a new tool for integration in clinical practice and clinical trials [51,55,57,62,74].…”