Using the 'Think Aloud' Technique to Explore Quality of Life Issues During Standard Quality-of-Life Questionnaires in Patients With Atrial Fibrillation

Ling Zhang; Robyn Gallagher; Nicole Lowres; Jessica Orchard; S Ben Freedman; Lis Neubeck

doi:10.1016/j.hlc.2016.05.121

Using the 'Think Aloud' Technique to Explore Quality of Life Issues During Standard Quality-of-Life Questionnaires in Patients With Atrial Fibrillation

Heart Lung Circ. 2017 Feb;26(2):150-156. doi: 10.1016/j.hlc.2016.05.121. Epub 2016 Jul 14.

Authors

Ling Zhang¹, Robyn Gallagher¹, Nicole Lowres¹, Jessica Orchard², S Ben Freedman³, Lis Neubeck⁴

Affiliations

¹ Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
² Sydney Medical School, University of Sydney, Sydney, NSW Australia.
³ Sydney Medical School, University of Sydney, Sydney, NSW Australia; Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Anzac Research Institute, Sydney, NSW, Australia.
⁴ Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia. Electronic address: lis.neubeck@sydney.edu.au.

PMID: 27469897
DOI: 10.1016/j.hlc.2016.05.121

Abstract

Aims and objectives: To investigate whether using the 'think aloud' technique during standard quality of life surveys provides useful additional information about patients' experiences of living with atrial fibrillation (AF) and health related quality of life (HRQoL).

Background: Atrial fibrillation is the most common cardiac arrhythmia and has serious health consequences, particularly ischaemic stroke, high rates of morbidity and mortality and poor HRQoL. Standard quality-of-life questionnaires are often used but may not provide sufficient detail of patients' experiences living with AF.

Design: A qualitative interpretative study based on semi-structured interviews.

Methods: Patients with AF (n=12) were recruited from the Choice of Health Options in Prevention of Cardiovascular Events-in Atrial Fibrillation (CHOICE-AF), a risk factor management program. Participants were interviewed using a 'think aloud' technique with questions guided by the AF Effects on Quality Of Life Questionnaire (AFEQT) and the Short Form-12 (SF-12). Interviews were audio-recorded, transcribed and analysed thematically.

Results: Participants had a median age of 71 years (interquartile range 52 to 77 years), and included four women and eight men. Four themes were identified related to experiences of living with AF and HRQoL including: (1) the adverse impact of atrial fibrillation symptoms, treatments, and related knowledge; (2) loss of function or independence; (3) the influence of age; and (4) approach to life.

Conclusions: Atrial fibrillation, especially in older adults, creates an additional layer of requirements for self-management onto existing self-care needs. Even for patients with relatively high HRQoL, the 'think aloud' technique together with standard HRQoL questionnaires can help identify additional issues that can be addressed by health professionals to improve the HRQoL of these patients.

Keywords: AF; Atrial fibrillation; HRQoL; Health related quality of life; Patient experience.

Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Publication types

Clinical Trial

MeSH terms

Adult
Atrial Fibrillation*
Female
Humans
Male
Middle Aged
Quality of Life*
Surveys and Questionnaires*