Shared decision making for anticoagulation reduces anxiety and improves adherence in patients with atrial fibrillation

被引:4
作者
Chiu, Hsiao-Hui [1 ,2 ]
Chang, Shih-Lin [1 ,2 ,3 ]
Cheng, Hao-Min [4 ]
Chao, Tze-Fan [4 ,5 ]
Lin, Yenn-Jiang [4 ,5 ]
Lo, Li-Wei [4 ,5 ]
Hu, Yu-Feng [4 ,5 ]
Chung, Fa-Po [4 ,5 ]
Liao, Jo-Nan [4 ,5 ]
Tuan, Ta-Chuan [4 ,5 ]
Lin, Chin-Yu [4 ,5 ]
Chang, Ting-Yung [4 ,5 ]
Kuo, Ling [4 ,5 ]
Liu, Chih-Min [4 ,5 ]
Tsai, Yung-Nan [5 ]
Huang, Yu-Ting [5 ]
Chang, Yuh-Lih [6 ,7 ,8 ]
Wung, Ju-Chieh [6 ]
Chen, Shih-Ann [4 ,5 ,9 ,10 ]
机构
[1] Taipei Vet Gen Hosp, Dept Nursing, Taipei, Taiwan
[2] Natl Taipei Univ Nursing & Hlth Sci, Dept Nursing, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med, Div Cardiol, Sec 2,Shih Pai Rd, Taipei 201, Taiwan
[4] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei, Taiwan
[5] Taipei Vet Gen Hosp, Heart Rhythm Ctr, Dept Med, Div Cardiol, Taipei, Taiwan
[6] Taipei Vet Gen Hosp, Dept Pharm, Taipei, Taiwan
[7] Natl Yang Ming Chiao Tung Univ, Dept Pharm, Taipei, Taiwan
[8] Natl Yang Ming Chiao Tung Univ, Inst Pharmacol, Coll Med, Taipei, Taiwan
[9] Taichung Vet Gen Hosp, Cardiovasc Ctr, Taichung, Taiwan
[10] Chung Hsing Univ, Coll Med, Taichung, Taiwan
关键词
Oral anticoagulants; Atrial fibrillation; Anxiety; Shared decision making; CHADS-VASc scores; Stroke; GUIDELINES; MANAGEMENT;
D O I
10.1186/s12911-023-02260-x
中图分类号
R-058 [];
学科分类号
摘要
BackgroundTreatment with oral anticoagulants (OACs) could prevent stroke in atrial fibrillation (AF), but side effects developed due to OACs may cause patients anxiety during decision making. This study aimed to investigate whether shared decision making (SDM) reduces anxiety and improves adherence to stroke prevention measures in patients with AF.MethodsA one-group pretest-posttest design using a questionnaire survey was applied at the outpatient cardiology clinic between July 2019 until September 2020. A Patient Decision Aid (PDA) tool was used for the completion of the questionnaire survey after health education and counseling. Ten questions were included for patients' recognition of SDM, and a 5-point scoring method was used, where "very much" was scored as 5 points, and "totally not" was scored as 1 point.ResultsFifty-two patients with AF were enrolled. In terms of patients' recognition of SDM, points of more than 4.17 out of 5 were noted, indicating recognition above the level of "very much." The patients' anxiety scores before SDM were 3.56 (1.2), with a decrease of 0.64 points (p < 0.001) to 2.92 (1.3) after SDM. After SDM, the number of patients who decided to take OAC increased from 76.9% to 88.5%, and the 15.4% answering "unclear" decreased to 1.9% (p = 0.006). The patients' anxiety levels after SDM were associated with gender (p = 0.025).ConclusionsThe approach using SDM enhanced our understanding of the pros and cons of OAC treatment and, in patients with AF, decreased anxiety about therapeutic decisions and increased willingness to accept treatment options.
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页数:6
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