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Factors associated with involvement in risk communication and confidence in shared decision making among patients with atrial fibrillation.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0003-3817-4981
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
Ryhov County Hospital, Jonkoping, Sweden, Department of Medicine, Jonkoping, Sweden.
Ryhov County Hospital, Jonkoping, Sweden, Department of Medicine, Jonkoping, Sweden.
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, S74-S75 p.Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Atrial fibrillation (AF) is a highly prevalent arrhythmia. Effective communication of risks (e.g., risk for stroke) and benefits to patients (e.g., treatment with oral anticoagulants) is crucial for shared decision making. Knowledge about how patients experience confidence and satisfaction in communication in relation to their health status is limited.

Aim: The aim was to explore factors associated with involvement in risk communication and confidence in shared decision making among patients with AF.

Method: A cross-sectional design was used and 322 patients (39 % women), mean age 67 years (SD 10.3 years) with AF were included at four hospitals in Sweden. Clinical examinations and self-rating scales for risk communication (COMRADE), uncertainty in illness (MUIS-C), depressive symptoms (HADS), mastery of daily life (MDL), as well as physical and mental health (SF-36) were used to collect data after a follow-up visit at the outpatient clinic 3 months post an AF episode.

Results: Paroxysmal, persistent and permanent AF occurred among 32%, 34% and 7% of the patients, respectively. Patients whom had undergone DC-conversion (53%) and had anticoagulants (37%). Seven percent had been treated by a percutan ablation. Heart failure (15%) and ischemic heart disease (12%) were the most common co-morbidities. CHA2DS2-VASc >2 were seen among 62% of the patients. Overall, multiple regression analyses showed that uncertainty in illness and mastery of daily life were significantly associated with confidence in decisions and uncertainty in illness and hypertension were significantly associated with satisfaction in communication. Higher uncertainty in illness and poorer mastery of daily life were associated with poor confidence in decisions. Higher uncertainty in illness and occurrence of hypertension were associated with poor satisfaction in communication. Clinical AF variables (i.e.,symptom or treatment related) or depressive symptoms were not significantly associated with satisfaction in communication or confidence in decisions in the multiple regression analysis. The final models explained 29% and 30% of the variance in confidence in decision making and satisfaction in communication.

Conclusion: In this cross-sectional study, including patients with AF, confidence in decision making and satisfaction in communication are associated with uncertainty in illness, mastery of daily life and hypertension.

Place, publisher, year, edition, pages
Sage Publications, 2017. Vol. 16, no Suppl. 1, S74-S75 p.
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
URN: urn:nbn:se:hj:diva-35917ISI: 000401775600126OAI: oai:DiVA.org:hj-35917DiVA: diva2:1106950
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2017-06-08Bibliographically approved

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Hedberg, BerithMalm, DanBroström, Anders

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