'It's like a frog leaping leaping about in your chest': Illness and treatment perceptions in patients with persistent atrial fibrillation

Journal article


Taylor, Elaina C, O'Neill, Mark, Carroll, Susan, Hughes, Lyndsay D and Moss-Morris, Rona 2017. 'It's like a frog leaping leaping about in your chest': Illness and treatment perceptions in patients with persistent atrial fibrillation. British Journal of Health Psychology. https://doi.org/10.1111/bjhp.12267.
AuthorsTaylor, Elaina C, O'Neill, Mark, Carroll, Susan, Hughes, Lyndsay D and Moss-Morris, Rona
Abstract

Persistent atrial fibrillation (AF) is an abnormal heart rhythm associated with low quality of life (QoL) and significant health-related costs. The purpose of the study was to examine patients’ illness and treatment beliefs and ways of coping with AF symptoms, to provide insight into promoting better QoL and treatment-specific management. Beliefs were explored across three procedural treatment-groups using a qualitative cross-sectional design. 30 semi-structured interviews were carried out with patients undertaking cardioversion (n=10), catheter ablation (n=11) and atrioventricular node ablation (n=9). Interviews were transcribed and analysed using inductive thematic analysis with elements of grounded theory. An overarching theme of a vicious cycle was evident, which related to perceived lack of knowledge and understanding of AF, attempts to control symptoms and negative emotional reactions to failed control attempts. This vicious cycle related to three subordinate themes (i) Unpredictability and uncertainty of AF and symptoms; (ii) Coping with symptoms through (a) avoidance (b) all-or-nothing- (c) slowing down behaviours; and (iii) Concerns and expectations about treatment. Patients outlined a need to gain control of unpredictable symptoms by monitoring and varying activity levels. These behaviours were often appraised as ineffective at controlling symptoms, leading to heightened uncertainty and increased activity-avoidance. Treatment concerns escalated with increasing number and invasiveness of procedures. Improving AF patients’ perceived understanding of their illness and treatment and promoting more effective symptom-management strategies may alleviate psychological distress and improve QoL. Themes elaborated on the Common-Sense-Model whereby patients’ beliefs about illness and treatment interact with coping behaviours.

Keywordsqualitative, atrial fibrillation, illness perceptions, treatment beliefs, catheter ablation, cardioversion, atrioventricular node ablation, common-sense model
Year2017
JournalBritish Journal of Health Psychology
PublisherWiley
ISSN1359-107X
2044-8287
Digital Object Identifier (DOI)https://doi.org/10.1111/bjhp.12267.
Web address (URL)http://hdl.handle.net/10545/624965
hdl:10545/624965
Publication dates05 Sep 2017
Publication process dates
Deposited09 Jul 2020, 14:19
Accepted2017
ContributorsKing's College London
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File Access Level
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https://repository.derby.ac.uk/item/93v98/-it-s-like-a-frog-leaping-leaping-about-in-your-chest-illness-and-treatment-perceptions-in-patients-with-persistent-atrial-fibrillation

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