Date of Final Presentation
Teresa Serratt, PhD, RN
Pam Strohfus, MA, DNP, RN, CNE
Coordinator/ Chair of DNP Program
Pamela Gehrke, EdD, RN
Abstract/ Executive Summary
Background: Patients at a community hospital verbalized fear, stress and anxiety about transcatheter aortic valve replacement (TAVR). Patients with aortic stenosis eligible for TAVR may experience low self-efficacy and anxiety while considering valve replacement which may lead to poor quality of life, interfere with understanding information from medical providers, and other health complications.
Methods: All patients eligible for TAVR between June and August of 2019 were invited to participate in a pilot project using peer support and use of shared decision-making (SDM) aids. Former TAVR patients were trained to be Mended Hearts TAVR peer volunteers. Participants were connected by telephone with a peer by the valve coordinator and SDM aids from the American College of Cardiology were initiated and reviewed during appointments. Patients’ anxiety and self-efficacy were measured before and after peer support using the General Anxiety Disorder-7 and the Cardiac Self-Efficacy scales. Patients evaluated the helpfulness of the SDM aids using the Preparation for Decision-Making scale and open-ended questions were used to gather additional information beyond questionnaire scale questions.
Results: Eleven TAVR patients evaluated anxiety and CSE and twelve patients evaluated the SDM aids. Post-GAD-7 scores showed four patients had a decrease in anxiety, five had no change, and two had an increased anxiety score. Post CSE scores showed increases in confidence for 58% of patients in one or more areas of self-efficacy and all patients rated the SDM aids as ‘somewhat to a great deal helpful’. All patients responded positively during interviews, stating that even if they felt confident before the interventions, they felt even greater confidence afterward.
Conclusion: The interventions empowered patients to discuss their health and procedural concerns and personal values with their medical team. Patients feel more confident with their decisions regarding TAVR after receiving peer support and the shared decision-making aids.
Einfeld, Kimberlee, "Implementation of Peer Support and Shared Decision-Making Aids for the Transcatheter Aortic Valve Replacement Population" (2020). Doctor of Nursing Practice. 33.