TRANSCATHETER AORTIC VALVE IMPLANTATION: PATIENTS’ PERSPECTIVE ON THEIR JOURNEY FROM REFERRAL TO FOLLOW-UP
2014
BACKGROUND: Severe aortic stenosis is a terminal heart disease associated with rapid clinical deterioration, significant symptom burden and reduced quality of life. In higher risk patients referred for transcatheter aortic valve implantation (TAVI), the complexity of the eligibility assessment and progression from referral to discharge pose significant challenges. Although clinical trials increasingly attest to positive short and longer term outcomes, little evidence exists to understand elderly patients’ unique needs throughout the trajectory of care. METHOD: Underpinned by an intersectionality theoretical framework, the study employed a focused ethnography to examine the medical, functional and social needs of this group as they go through the TAVI process. We conducted a series of semi-structured interviews and participant observations in a purposive sample of patients, informal caregivers, and healthcare providers throughout the TAVI process, including: at the time of eligibility assessment, prior to the procedure, and during the early recovery period. ANALYSIS: Data was organized using NVivo 10 software, and systematically coded and analyzed to identify emerging themes. In-depth analysis was conducted to focus on synthesizing findings. FINDINGS AND DISCUSSION: We will present early findings exploring the patients’ perspectives on the TAVI process, including: factors contributing to decision-making to have a TAVI, the experience of receiving care at a provincial centre, and the supports required to successfully navigate the waiting period and recovery at home following the procedure. We will discuss the implications for cardiovascular nursing practice to support TAVI program development and specialized health services planning for transcatheter heart valve innovations.
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