Living with atrial fibrillation: a qualitative study.

BACKGROUND AND RESEARCH
OBJECTIVE: Atrial fibrillation (AF) is a public health burden associated with stroke, cardiomyopathy, and diminished quality of life (QOL). Although surveys suggest that AF impairs physical functioning and mental health, little is known about patients' experiences contributing to those findings. Understanding patients' experiences of living with AF may provide a foundation for interventions to improve QOL. In this qualitative descriptive study, we describe the experience of living with recurrent symptomatic AF from patients' perspectives. SUBJECTS AND METHODS: Seven women and 8 men, recruited from a Midwest medical center, with a mean age of 59.8 (SD, 14.5) years, diagnosed with recurrent symptomatic AF, participated in open-ended interviews. Data were analyzed by qualitative descriptive methods. RESULTS AND
CONCLUSIONS: Themes were identified that reveal experiences of living with recurrent symptomatic AF over time and how AF may diminish QOL. Themes included (1) finding the meaning of symptoms, (2) feeling uninformed and unsupported, (3) turning points, (4) steering clear of AF, (5) managing unpredictable and function limiting symptoms, (6) emotional distress, and (7) accommodation to AF tempered with hope for a cure. Participants experienced delays in diagnosis and minimization of their concerns by clinicians and others and did not receive counseling regarding the nature of AF and self-management. Strategies to manage AF and its symptoms were learned through trial and error and were transiently effective. Support for coping with the emotional burden of AF was lacking. Interventions to improve recognition of AF symptoms and promote prompt evaluation and treatment are needed. Psychoeducational programs to teach patients and families about the nature of AF, guide self-management, and address the emotional burden of AF need to be developed and tested.