Peri-procedure experiences during minimalist transcatheter aortic valve implantation: insights from patients' perspectives
Notice bibliographique
Résumé
Abstract Funding Acknowledgements Type of funding sources: None. Background There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve program capacity, and facilitate safe early discharge home after transcatheter aortic valve implantation (TAVI). In the peri-procedure phase, the adoption of a minimalist approach has accelerated the rapid transition from the use of general anaesthesia to default strategies ranging from conscious sedation to local anaesthesia only. Little is known of patients’ perspectives with undergoing minimalist TAVI. We aimed to explore what could be learned from this episode of care to inform multidisciplinary practice. Methods We conducted a prospective single centre qualitative study of TAVI patients within the first week of their discharge home, using purposeful sample to recruit a diverse population. We conducted individual interviews, using a semi-structured interview guide informed by pilot work and current evidence; open-ended questions were designed to explore patients’ perspectives of their peri-procedural experiences, inclusive of their recall of the procedure, interactions with team members, and the overall care received. Data were analyzed using interpretive description, a methodological approach appropriate to inform the knowledge needs of applied disciplines and conducive to generating new ideas and augment existing knowledge in the context of clinical practice. Results We recruited 15 participants, including 5 women, median age 82 (IQR 77,86); all patients had severe symptomatic aortic stenosis and multiple co-morbidities. TAVI was conducted using a transfemoral approach, with local anaesthesia only (n=4) or minimal sedation (n=11). Median length of stay was 1 day; one participant required a new permanent pacemaker; all participants were discharged home. The overarching theme of "I want to be a member of my Heart Team during my procedure" emerged; this aspiration, request and/or need was illustrated by three main themes: (1) "Who am I to them?", (2) "How can I be a good patient?", and (3) "How do I manage this complex wave of emotions?". Conclusions The rapid emergence of minimally invasive options for the treatment of valvular heart disease has established a new standard of care. Peri-procedure care initially informed by surgical practices have now shifted to most patients being conscious during TAVI and cared for by a smaller clinical team. The awareness of patients’ perspectives, and their inclusion in the Heart Team’s dynamics and processes offer important insights to optimise patients’ experiences of procedural care and clinical outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,005 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».