Educational Needs of People Living with Atrial Fibrillation: A Qualitative Study.
Caleb FergusonLouise D HickmanLien LombardoAnnie DownieBeata BajorekSerra IvynianSally C InglisRochelle WynnePublished in: Journal of the American Heart Association (2022)
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.
Keyphrases
- atrial fibrillation
- healthcare
- quality improvement
- palliative care
- acute care
- heart failure
- catheter ablation
- end stage renal disease
- left atrial
- oral anticoagulants
- depressive symptoms
- magnetic resonance
- chronic kidney disease
- ejection fraction
- case report
- patient reported outcomes
- pain management
- social support
- cancer therapy
- direct oral anticoagulants
- percutaneous coronary intervention
- risk factors
- drug delivery
- computed tomography
- coronary artery disease
- clinical practice
- patient reported
- mitral valve
- health insurance
- affordable care act
- contrast enhanced