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房颤患者的教育需求:一项定性研究。

Educational Needs of People Living with Atrial Fibrillation: A Qualitative Study.

机构信息

Western Sydney Nursing & Midwifery Research Centre Western Sydney Local Health District and Western Sydney University, Blacktown Hospital Blacktown New South Wales Australia.

School of Nursing University of Wollongong Wollongong New South Wales Australia.

出版信息

J Am Heart Assoc. 2022 Aug 2;11(15):e025293. doi: 10.1161/JAHA.122.025293. Epub 2022 Jul 25.

Abstract

Background This study explored the educational and self-management needs of adults living with atrial fibrillation (AF). Methods and Results This is a qualitative study of adults living with AF, clinicians, and expert key stakeholders. Interviews were conducted via a one-to-one semistructured videoconference or phone and transcribed verbatim for thematic analysis. A total of 34 participants were recruited and included in analyses (clinicians n=13; experts n=13, patients n=8). Interviews were on average 40 (range 20-70) minutes in duration. Three key themes were identified: (1) "Patient-centered AF education"; (2) "Prioritizing AF education"; and (3) "Timing AF education." The availability of credible information was perceived as highly variable. Information primarily focused on anticoagulation, or procedural information, as opposed to other aspects of management, such as risk factor reduction. Factors to optimize learning, such as multimedia, apps, case studies, or the use of visuals were perceived as important. Continuity of care, including engagement of caregivers, was important to help develop relationships, and facilitate understanding, while concurrently creating opportunities for timely targeted education. Clinicians described acute care as a suboptimal setting to deliver education. Competing interests aligned with the time-pressured context of acute care were prioritized over patient education. In contrast, patients valued continuity of care. AF education strategies need to pivot from a "one size fits all" approach and modernize to implement a range of approaches. Conclusions There remain many unmet needs in the provision of quality AF education to support self-management. Multimodal offerings and the ability to tailor to individual patient needs are important design considerations for new education programs.

摘要

背景 本研究探讨了成年人患有心房颤动(AF)的教育和自我管理需求。

方法和结果 这是一项针对成年人、临床医生和专家关键利益相关者的心房颤动患者的定性研究。通过一对一的半结构化视频会议或电话进行访谈,并逐字记录进行主题分析。共招募了 34 名参与者并进行了分析(临床医生 n=13;专家 n=13,患者 n=8)。访谈平均持续 40 分钟(范围 20-70 分钟)。确定了三个关键主题:(1)“以患者为中心的 AF 教育”;(2)“优先考虑 AF 教育”;(3)“安排 AF 教育时间”。可获得的可信信息被认为差异很大。信息主要集中在抗凝或程序信息上,而不是管理的其他方面,例如危险因素的降低。优化学习的因素,如多媒体、应用程序、案例研究或使用视觉效果,被认为很重要。连续护理,包括照顾者的参与,对于建立关系、帮助理解以及同时为有针对性的及时教育创造机会非常重要。临床医生将急性护理描述为提供教育的次优环境。与急性护理时间紧迫相关的利益竞争优先于患者教育。相比之下,患者重视连续护理。AF 教育策略需要从“一刀切”的方法转变,并采用多种方法进行现代化。

结论 在提供优质 AF 教育以支持自我管理方面,仍存在许多未满足的需求。多模式提供和能够针对个体患者需求进行调整是新教育计划的重要设计考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2613/9375481/7b40a09d4749/JAH3-11-e025293-g001.jpg

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