UBC Faculty Research and Publications

The Diverse Journeys of Rural Older Adults with Atrial Fibrillation Rush, Kathy L.; Oelke, Nelly; Shay, Matt; Reid, Robert Colin


Rationale, Aims, 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 health care 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 journey of rural living older adults. Method: This study used a 6-month longitudinal design to examine the rural health-care 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 health care 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 three journey types: 1) Stable, 2) Chronically Unstable, and 3) Acute Crisis. Conclusions: These journey types provide a valuable 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.

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