Patients' experiences across the trajectory of atrial fibrillation: A qualitative systematic review

Abstract

Aim: This study aimed to synthesize qualitative evidence on experiences of patients with atrial fibrillation (AF) during the course of diagnosis and treatment. We addressed three main questions: (a) What were the experiences of patients with AF during the course of diagnosis and treatment? (b) How did they respond to and cope with the disease? (c) What were the requirements during disease management? Design: In this study, qualitative evidence synthesis was performed using the Thomas and Harden method. Data Sources: Electronic databases, including PubMed, the Cochrane Library, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the China Biomedical Database, the WanFang Database, Chinese National Knowledge Infrastructure and VIP, were searched. The databases were searched from inception to August 2021.Review Methods: Two researchers independently selected studies using qualitative assessment and review instruments for quality evaluation and thematic synthesis for the data analysis.Results: A total of 2627 studies were identified in the initial search and 15 studies were included. Five analytical themes were generated: 'Diagnosing AF'; 'The impact of AF on the patients'; 'Self-reorientation in the therapeutic process'; 'Living with AF and QoL'; and 'External support to facilitate coping strategies.' Conclusions: Our findings point out unique experiences of patients across the trajectory of AF related to delayed diagnosis, feelings of nonsupport, disappointment of repeated treatment failure and multiple distress associated with unpredictable symptoms. Future research and clinical practice are expected to improve the quality of medical diagnosis and treatment, optimize administrative strategy and provide diverse health support for patients with AF.

Trajetórias assistenciais de usuários com COVID-19: das medidas preventivas à reabilitação

“…Foram entrevistados 27 participantes, sendo a maioria composta por pessoas: acima de 60 anos (18); com renda familiar de até 2 salários mínimos (17); que recebiam algum tipo de benefício social (17); que tinham uma unidade da Estratégia Saúde da Família (ESF) como primeiro contato (14); se declararam negros ou pardos (15); e viviam com o cônjuge (17).…”

“…Trata-se de um estudo avaliativo com abordagem qualitativa para produção das trajetórias assistenciais de usuários que tiveram a experiência de diagnóstico, internação e reabilitação decorrentes da COVID-19 no Município de Niterói, Rio de Janeiro, Brasil. As trajetórias assistenciais são utilizadas para a avaliação da organização e prestação de serviços de saúde com base nas estratégias e caminhos traçados pelos usuários na busca por cuidados 18 . Representam práticas avaliativas que, fundamentadas nas vivências de adoecimento, permitem identificar constrangimentos, facilidades no uso e acesso às RAS e qualidade do cuidado 19 , o que se justifica no caso de uma condição de saúde -COVID-19 -cujos padrões de intervenção e de avaliação carecem de estudos e produção de evidências.…”

Care trajectories of COVID-19 patients: from preventive measures to rehabilitation

“…Twenty-seven participants were interviewed, most of whom were over 60 years old (18); with family income of up to two minimum wages (17); who received some type of social benefit (17); whose first contact with health services was through the Family Health Strategy (FHS) (14); who self-declared black or brown (15); and who lived with their spouse (17). Eight participants reported having some kind of private health insurance, including low-cost plans paid by month and coinsurance systems for outpatient appointments and lab tests.…”

“…This is an evaluative study with a qualitative approach aimed at the production of care trajectories of COVID-19 patients with experiences of diagnosis, hospitalization and rehabilitation in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories are used to evaluate the organization and provision of health services based on the strategies and means used by patients in their search for care 18 . They represent evaluative practices that, based on the experiences of illness, enable the identification of constraints, conditions of use and access to HN and quality of care 19 , which is justified in the case of a health condition -COVID-19 -whose patterns of intervention and evaluation lack studies and evidence.…”

A qualitative crossroads of rhythm and race: Black patients' experiences living with atrial fibrillation

“…Patients' lived experiences of their chronic conditions alter their self-management, which in turn affects patients' health habits, risk factors, and health outcomes. Few studies have qualitatively investigated the individual experience of AF, and none have done so in Black individuals [ 9 - 12 ]. The sparse qualitative data that has been collected from individuals with AF suggests themes of physical limitations, emotional stress, and lack of health education that affect patients' self-management [ 9 - 11 ].…”