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Understanding experiences of undergoing transcatheter aortic valve implantation: one-year follow-up.

Authors
  • Baumbusch, Jennifer1
  • Lauck, Sandra B2
  • Achtem, Leslie2
  • O'Shea, Tamar1
  • Wu, Sarah3
  • Banner, Davina4
  • 1 1 School of Nursing, University of British Columbia, Canada. , (Canada)
  • 2 2 St Paul's Hospital, Vancouver, Canada. , (Canada)
  • 3 3 Department of Kinesiology, University of Waterloo, Canada. , (Canada)
  • 4 4 School of Nursing, University of Northern British Columbia, Canada. , (Canada)
Type
Published Article
Journal
European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology
Publication Date
Mar 01, 2018
Volume
17
Issue
3
Pages
280–288
Identifiers
DOI: 10.1177/1474515117738991
PMID: 29087216
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Transcatheter aortic valve implantation (TAVI) is the treatment of choice for frail, older adults with severe symptomatic aortic stenosis. Although research about long-term clinical outcomes is emerging, there is limited evidence from the perspectives of patients and family caregivers on their perceived benefits and challenges after TAVI. The aim of this study was to describe older adults and family caregivers' perspectives on undergoing TAVI at one year post-procedure. Qualitative description was the method of inquiry. A purposive sample of 31 patients and 15 family caregivers was recruited from a TAVI programme in western Canada. Semi-structured interviews were conducted with participants one year after TAVI. Data were analysed thematically. All participants were satisfied with the decision to undergo TAVI. There were three central themes. First, recovery was experienced in the context of aging and comorbidities, which was shaped by patients' limited options for care and post-procedure symptom burden. Second, reconciling expectations with reality meant that, for some patients, symptom burden remained prevalent and was also influenced by others' expectations. Third, recommendations for recovery related to having information needs met, keeping informed of evolving care processes, and addressing individualised needs for support. The perspectives of participants provide a valuable contribution to the literature about undergoing TAVI. Clinicians need to be attentive to patients' expectations of benefit and temper these with consideration of the individual's broader health situation to provide treatment decision support. Patients and family caregivers also need adequate teaching and support to facilitate safe transition home given the shift towards early discharge after TAVI.

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