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Transforming the experience of aortic valve disease in older patients: A qualitative study

Bettina Højberg Kirk, Ole De Backer and Malene Missel

Journal of Clinical Nursing, 2019, vol. 28, issue 7-8, 1233-1241

Abstract: Aim and objectives To explore patients’ lived experiences of daily life and coping with recovery after transcatheter aortic valve implantation (TAVI). Background Transcatheter aortic valve implantation is increasingly used to treat older patients with severe aortic stenosis with high surgical risk. This novel treatment has been shown to be effective in relieving symptoms, improving survival and prognosis, but its impact on patients’ daily life has been sparsely explored. Design Qualitative design. Methods Qualitative interviews were conducted in a purposeful sample of ten patients three‐four months after TAVI. A phenomenological hermeneutical approach comprised an epistemological stance and Ricoeur's work inspired the qualitative methodological foundation. The study adhered to the COREQ guidelines. Results This study is illuminating patients’ perception of recovery after TAVI. The patients experienced a transformation of bodily sensations, a changed bodily attention and enhanced physical possibilities to cope with life. Undergoing TAVI changed the pre‐treatment symptoms that limited daily activities, allowing the patients to resume or participate in activities that were previously impossible. TAVI gives patients the feeling that they can do more than before, which strengthens their faith in the body's possibilities and means that they can live a more self‐reliant and independent life. Conclusion For older patients, TAVI can serve to bolster a sense of trusting their own body again. A clear distinction between pre‐ and post‐TAVI is recognised. Patients may be able to resume everyday activities following TAVI. The recovery process, however, must take into account the individual patient's own resources. Relevance to clinical practice The impact of TAVI on daily life activities should be communicated to the patient in decision‐making. Recovery depends on the patient's own effort, why identification of the patients who need support for recovery after TAVI as well as differentiated rehabilitation is required. Walking as a parameter should be integrated in the recovery trajectory.

Date: 2019
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https://doi.org/10.1111/jocn.14732

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