title: Experiences of and Coping With Severe Aortic Stenosis Among Patients Waiting for Transcatheter Aortic Valve Implantation.
abstract: BACKGROUND
  Aortic stenosis (AS) is the most common valve disease in Western countries. Transcatheter aortic valve implantation (TAVI) has made it possible to treat patients with higher surgical risks. These patients are informed about their poor prognosis with only months or a few years to live without treatment. Because of their severe symptoms, limitations, and suffering, patients awaiting TAVI need special attention.
  
  
  OBJECTIVE
  The aim of this study is to describe patients' experiences of coping with severe AS and of waiting for TAVI.
  
  
  METHODS
  Swedish participants (n = 24; 9 women, 15 men) with a mean (SD) age of 80 (7.4) years who had been offered TAVI all agreed to participate in a presurgical interview. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis.
  
  
  RESULTS
  The participants' experiences of coping with AS and awaiting TAVI were described by the main theme "living on the edge, but trying to stay in control," which comprised 3 categories: "trying to cope with physical symptoms and anxiety," "trying to preserve self and self-esteem despite life-threatening illness," and "trying to process the decision to undergo TAVI."
  
  
  CONCLUSIONS
  Patients with AS and awaiting TAVI must cope with increasing symptoms and limitations in their social lives but still wish to be seen as the people they always have been. These patients may need extra support from healthcare personnel to process their experiences, which could help them to attach personal meaning to clinical information about the condition and its treatment that they could include in their decision about whether to undergo TAVI. Listening to patients' stories could help nurses and physicians to ensure that disease and treatment are meaningfully understood by the patient.
authors: Karin Olsson, RN, MSc PhD Student, Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, and Department of Nursing, Umeå University, Sweden.Ulf Näslund, MD, PhD Professor, Cardiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden.Johan Nilsson, MD, PhD Researcher, Cardiology, Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Sweden.Åsa Hörnsten, RN, PhD Professor, Department of Nursing, Umeå University, Sweden.
authors: Karin
authors: K
authors: Olsson
authors: Ulf
authors: U
authors: Näslund
authors: Johan
authors: J
authors: Nilsson
authors: Åsa
authors: Å
authors: Hörnsten
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001024:Aortic Valve Stenosis / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D012649:Self Concept; D013548:Sweden; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement; D014850:Waiting Lists