UCSF

Background: Atrial fibrillation (AF) currently is projected to affect 15 million by 2050. Despite current efforts to restore normal rhythm, AF persists and symptoms prevail, along with a compromised quality of life (QOL). Symptoms associated with PAF can be disabling, often disproportionate to the severity of disease. In addition, a health perception more aligned with illness than wellness has been associated with greater symptoms and decreased QOL. There is a need for effective and affordable interventions focused on symptom reduction and improved QOL.

Objective: The specific aims: 1) Explore the lived experience of patients with PAF and collect ideas on essential resources for managing PAF, 2) Develop a conceptual related to the clinical experience of living with PAF, 3) Determine the feasibility and efficacy potential of meditation and education intervention to reduce symptoms, decrease negative illness perception, and improve symptom outcomes (QOL and functional status).

Method: A conceptual model was developed and two studies were completed; a constructivist Grounded Theory qualitative study, Experiences and Perceived Needs of Individuals Living with Paroxysmal Atrial Fibrillation, and a mixed methods study, A Feasibility and Efficacy Study of a Nurse Delivered Mindfulness-Education Intervention for Paroxysmal Atrial Fibrillation Patients to Reduce Symptoms, Decrease Negative Illness Perception, and Improve QOL and functional outcomes.

Results: The qualitative study resulted in major categories: Disruptive Symptoms, Altered Health Perception, AF Action Plan, and Quality of Life were constructed. The development of the theoretical code, “Designing Strategies to Enable Living Well with PAF” provides a conceptual model for improved understanding of individuals with PAF and for designing and evaluating interventions that may result in improved outcomes.

For MEND AF, the intervention was deemed feasible. A statistically significant reduction in AF symptom frequency and severity was found. Anxiety, fatigue and sleep disturbance scores were decreased; but not significantly. A significant improvement in QOL and the subscales, Treatment Concern and Symptom Severity was also found.

Conclusions: This study enabled the development of a novel conceptual model that can be used to design future patient interventions. The model will provide a foundation for intervention testing, but likewise, will allow testing of the model.