Zhang Ling, Gallagher Robyn, Lowres Nicole, Orchard Jessica, Freedman S Ben, Neubeck Lis
Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
Sydney Medical School, University of Sydney, Sydney, NSW Australia.
Heart Lung Circ. 2017 Feb;26(2):150-156. doi: 10.1016/j.hlc.2016.05.121. Epub 2016 Jul 14.
To investigate whether using the 'think aloud' technique during standard quality of life surveys provides useful additional information about patients' experiences of living with atrial fibrillation (AF) and health related quality of life (HRQoL).
Atrial fibrillation is the most common cardiac arrhythmia and has serious health consequences, particularly ischaemic stroke, high rates of morbidity and mortality and poor HRQoL. Standard quality-of-life questionnaires are often used but may not provide sufficient detail of patients' experiences living with AF.
A qualitative interpretative study based on semi-structured interviews.
Patients with AF (n=12) were recruited from the Choice of Health Options in Prevention of Cardiovascular Events-in Atrial Fibrillation (CHOICE-AF), a risk factor management program. Participants were interviewed using a 'think aloud' technique with questions guided by the AF Effects on Quality Of Life Questionnaire (AFEQT) and the Short Form-12 (SF-12). Interviews were audio-recorded, transcribed and analysed thematically.
Participants had a median age of 71 years (interquartile range 52 to 77 years), and included four women and eight men. Four themes were identified related to experiences of living with AF and HRQoL including: (1) the adverse impact of atrial fibrillation symptoms, treatments, and related knowledge; (2) loss of function or independence; (3) the influence of age; and (4) approach to life.
Atrial fibrillation, especially in older adults, creates an additional layer of requirements for self-management onto existing self-care needs. Even for patients with relatively high HRQoL, the 'think aloud' technique together with standard HRQoL questionnaires can help identify additional issues that can be addressed by health professionals to improve the HRQoL of these patients.
探讨在标准生活质量调查中采用“大声思考”技术是否能提供有关房颤（AF）患者生活经历及健康相关生活质量（HRQoL）的有用补充信息。
房颤是最常见的心律失常，会产生严重的健康后果，尤其是缺血性中风、高发病率和死亡率以及较差的HRQoL。标准生活质量问卷经常被使用，但可能无法提供患者房颤生活经历的足够细节。
基于半结构化访谈的定性解释性研究。
从预防心血管事件——房颤的健康选择（CHOICE - AF）这一危险因素管理项目中招募房颤患者（n = 12）。采用“大声思考”技术对参与者进行访谈，问题由房颤对生活质量问卷（AFEQT）和简短健康调查问卷（SF - 12）引导。访谈进行录音、转录并进行主题分析。
参与者的年龄中位数为71岁（四分位间距为52至77岁），包括4名女性和8名男性。确定了与房颤生活经历和HRQoL相关的四个主题，包括：（1）房颤症状、治疗及相关知识的不利影响；（2）功能或独立性丧失；（3）年龄的影响；（4）生活态度。
房颤，尤其是在老年人中，在现有自我护理需求之上增加了一层自我管理要求。即使对于HRQoL相对较高的患者，“大声思考”技术与标准HRQoL问卷相结合也有助于识别健康专业人员可以解决的其他问题，以改善这些患者的HRQoL。
