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The Diverse Journeys of Rural Older Adults with Atrial Fibrillation

Kathy L Rush, Nelly D Oelke, Matt Shay, Robert C Reid

Abstract


Rationale, aims and objectives: Atrial fibrillation (AF) is a serious chronic heart condition characterized by an irregular, rapid heartbeat and unpredictable course. Patients with AF often struggle with managing the impact of the disease on daily activities.  Afflicted rural dwelling patients face added challenges including inequities in health services and a lack of cardiac specialty services. AF patient journeys through the healthcare system have not been well documented, but offer a valuable tool for improving patient management and outcomes. The purpose of this study was to document individual AF patient journeys of rural living older adults.

Method: This study used a 6-month longitudinal design to examine the rural healthcare experiences of 10 AF patients. AF patient journeys were mapped using information gathered through interviews, written logs, photographs and an electronic health record review. Thematic analysis was used in clustering common features of the healthcare journeys of older adult patients with AF and a typology developed to describe them. 

Results: Each patient’s journey with AF was unique. Symptom and disease severity, health service utilization and needs emerged as differentiating features in the identification of 3 journey types: (1) Stable, (2) Chronically Unstable and (3) Acute Crisis.

Conclusions: These journey types provide a valuable person-centered tool to assess patient needs at any point in the AF trajectory and to address salient risks that accompany each type to improve management of the increasing number of persons suffering from AF.


Keywords


Atrial fibrillation, cardiac, health service delivery, integrated services, older adults, patient journey, person-centered healthcare, risk evaluation, rural, self-management

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References


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DOI: http://dx.doi.org/10.5750/ejpch.v3i4.1022

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