Department of Cardiology, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
J Clin Nurs. 2018 Feb;27(3-4):601-611. doi: 10.1111/jocn.13951. Epub 2017 Nov 10.
To gain in-depth knowledge of patients' experiences of the consultation processes at a multidisciplinary atrial fibrillation outpatient clinic in a university hospital in Denmark.
Atrial fibrillation is the most common cardiac arrhythmia associated with morbidity and mortality if not diagnosed and treated as recommended. Patients with newly diagnosed atrial fibrillation preferably should be managed in an outpatient setting which includes medical examination, patient education and decision-making on medical therapy.
This is a qualitative study of 14 patients newly diagnosed with atrial fibrillation, ranging from asymptomatic patients, to those with mild to severe symptoms; they were all referred from general practitioners.
Data were generated in 2013-2015 using participant observation during each consultation, followed by individual interviews postconsultation.
Patients were referred with limited information on AF and knowledge about the management consultation procedures. The consultations were performed in a professional way by the cardiologist as well as by the nurses with an emphasis on the medical aspects of atrial fibrillation. The understanding that atrial fibrillation is not a fatal disease in itself was very important for patients. At the same time, visiting the clinic was overwhelming, information was difficult to understand, and patients found it difficult to be involved in decision-making.
This study indicates that patients were uncertain on what AF was before as well as after their consultation. The communication was concentrated on the medical aspects of atrial fibrillation and visiting the clinic was an overwhelming experience for the patients. They had difficulty understanding what atrial fibrillation was, why they were treated with anticoagulation, and that anticoagulating was a lifelong treatment.
This study demonstrates some lack of patient-centred care and an absence of tailored patient AF-related education. Furthermore, the study highlights the need for and importance of active patient involvement.
深入了解丹麦一所大学附属医院多学科心房颤动门诊就诊过程中患者的体验。
心房颤动是最常见的心律失常，如果未按建议进行诊断和治疗，会导致发病率和死亡率增加。新诊断为心房颤动的患者最好在门诊进行管理，包括体格检查、患者教育以及对药物治疗的决策。
这是一项针对 14 名新诊断为心房颤动的患者的定性研究，患者的症状从无症状到轻度到重度不等；他们均由全科医生转诊而来。
数据于 2013-2015 年通过每次就诊时的参与者观察以及就诊后进行的个人访谈收集。
患者转诊时对心房颤动的了解有限，对管理咨询程序的了解也有限。该咨询由心脏病专家和护士以专业的方式进行，重点关注心房颤动的医学方面。患者认为心房颤动本身并不是一种致命的疾病，这一点非常重要。与此同时，就诊过程让患者感到不知所措，信息难以理解，且患者发现难以参与决策。
本研究表明，患者在就诊前和就诊后都不确定心房颤动是什么。沟通主要集中在心房颤动的医学方面，就诊对患者来说是一种压倒性的体验。他们难以理解什么是心房颤动、为什么要接受抗凝治疗，以及抗凝治疗是一种终身治疗。
本研究表明，患者在接受治疗过程中缺乏以患者为中心的护理和个体化的心房颤动相关教育。此外，该研究强调了患者积极参与的必要性和重要性。
