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Al-Bashaireh AM, Alkouri O, Alharbi A, Khader Y, Hammoudeh A, Aljawarneh Y, Alotaibi NE, Qaladi O, Ababneh A, Schultz T. Factors Associated with Quality of Life among People with Atrial Fibrillation: Jordan Atrial Fibrillation Registry Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1262. [PMID: 39202543 PMCID: PMC11356530 DOI: 10.3390/medicina60081262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Atrial fibrillation (AF) is a common arrhythmia that may adversely affect the quality of life (QoL). Several factors could be associated with the QoL among patients with AF; however, evidence regarding these factors is still limited and controversial. Therefore, this study aimed to identify the level of QoL and its associated factors among Jordanian patients with AF. Subjects and methods: A case study design was implemented. A sample of 620 participants were recruited from 28 outpatient clinics registered in the Jordan atrial fibrillation registry AF (JoFIB). Data on QoL were gathered through the self-reported Atrial Fibrillation Effect on Quality-of-life tool (AFEQT). A QoL questionnaire was validated in this population before starting this study. The cardiac nurse then provided the research assistant with data relating to patients' characteristics and associated comorbidities. Results: The overall AFEQT scores were positively skewed (median 21.3, IQR: 14.4-31.9). This pattern was reflected for the AFEQT sub-scales 'Symptoms' (20.8, 8.3-33.3), 'Daily activities' (16.7, 10.4-27.1), and 'Treatment concerns' (27.8, 19.4-41.7), whereas 'Treatment satisfaction' was negatively skewed (91.7, 83.3-91.7). Patients in the higher quartiles, indicating a better QoL, tended to be younger and were less likely to experience dyslipidemia, stroke, pulmonary hypertension, or other comorbidities. Over 90% of patients were currently experiencing AF, and patients with a better QoL tended to be less likely to be currently experiencing AF and more likely to have had their latest episode of AF more than a month ago (compared to less than a month ago). Age, BMI, dyslipidemia, heart failure, COPD, CAD, history of ablation, and the use of anticoagulants were significantly associated with the overall AFEQT score (R2 = 0.278). Conclusions: This study demonstrates that AF Jordanian patients had low levels of QoL. Patients in higher quartiles for the overall AFEQT score were younger, with fewer disease comorbidities and less experience of current AF episodes. Several modifiable and non-modifiable factors were associated with QoL in AF patients. Age, BMI, dyslipidemia, heart failure, COPD, CAD, history of ablation, and the use of oral anticoagulants were significantly associated with the overall AFEQT score. Healthcare providers should target these factors as indicators or interventions for which QoL is continuously monitored.
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Affiliation(s)
- Ahmad M. Al-Bashaireh
- Department of Nursing, Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi P.O. Box 1626, United Arab Emirates; (A.M.A.-B.); (Y.A.)
| | - Osama Alkouri
- Faculty of Nursing, Yarmouk Univerity, P.O. Box 566, Irbid 21163, Jordan;
| | | | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, Irbid 21163, Jordan;
| | | | - Yousef Aljawarneh
- Department of Nursing, Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi P.O. Box 1626, United Arab Emirates; (A.M.A.-B.); (Y.A.)
| | - Nader E. Alotaibi
- Medical Surgical Nursing Department, College of Nursing, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Omar Qaladi
- Community and Psychiatric Mental Health Nursing Department, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Anas Ababneh
- Faculty of Nursing, Yarmouk Univerity, P.O. Box 566, Irbid 21163, Jordan;
| | - Tim Schultz
- Flinders Health and Medical Research Institute, Flinders University, Sturt Road, Bedford Park South Australia 5042, P.O. Box 2100, Adelaide, SA 5001, Australia;
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Ferguson C, Hickman LD, Lombardo L, Downie A, Bajorek B, Ivynian S, Inglis SC, Wynne R. Educational Needs of People Living with Atrial Fibrillation: A Qualitative Study. J Am Heart Assoc 2022; 11:e025293. [PMID: 35876410 PMCID: PMC9375481 DOI: 10.1161/jaha.122.025293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/16/2022] [Indexed: 12/01/2022]
Abstract
Background This study explored the educational and self-management needs of adults living with atrial fibrillation (AF). Methods and Results This is a qualitative study of adults living with AF, clinicians, and expert key stakeholders. Interviews were conducted via a one-to-one semistructured videoconference or phone and transcribed verbatim for thematic analysis. A total of 34 participants were recruited and included in analyses (clinicians n=13; experts n=13, patients n=8). Interviews were on average 40 (range 20-70) minutes in duration. Three key themes were identified: (1) "Patient-centered AF education"; (2) "Prioritizing AF education"; and (3) "Timing AF education." The availability of credible information was perceived as highly variable. Information primarily focused on anticoagulation, or procedural information, as opposed to other aspects of management, such as risk factor reduction. Factors to optimize learning, such as multimedia, apps, case studies, or the use of visuals were perceived as important. Continuity of care, including engagement of caregivers, was important to help develop relationships, and facilitate understanding, while concurrently creating opportunities for timely targeted education. Clinicians described acute care as a suboptimal setting to deliver education. Competing interests aligned with the time-pressured context of acute care were prioritized over patient education. In contrast, patients valued continuity of care. AF education strategies need to pivot from a "one size fits all" approach and modernize to implement a range of approaches. Conclusions There remain many unmet needs in the provision of quality AF education to support self-management. Multimodal offerings and the ability to tailor to individual patient needs are important design considerations for new education programs.
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Affiliation(s)
- Caleb Ferguson
- Western Sydney Nursing & Midwifery Research CentreWestern Sydney Local Health District and Western Sydney University, Blacktown HospitalBlacktownNew South WalesAustralia
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
| | - Louise D. Hickman
- School of NursingUniversity of WollongongWollongongNew South WalesAustralia
| | - Lien Lombardo
- Western Sydney Nursing & Midwifery Research CentreWestern Sydney Local Health District and Western Sydney University, Blacktown HospitalBlacktownNew South WalesAustralia
| | - Annie Downie
- Department of CardiologyThe Sutherland HospitalCaringbahAustralia
| | - Beata Bajorek
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Serra Ivynian
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Sally C. Inglis
- Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research CentreWestern Sydney Local Health District and Western Sydney University, Blacktown HospitalBlacktownNew South WalesAustralia
- School of Nursing & MidwiferyDeakin UniversityGeelongAustralia
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