Background 

Atrial fibrillation (AF), the most common form of dysrhythmia, steadily increases in prevalence with age. If left untreated, AF significantly increases the risk of stroke, heart failure, and death. Despite the increasing prevalence, there are significant research gaps in the prediagnosis symptom experiences of patients with AF.

Objective 

The purpose of this qualitative descriptive study was to explore the prediagnosis symptom experience of patients with AF.

Methods 

Participants 19 years or older with AF diagnosed in the previous year were recruited (n = 26) from outpatient cardiac rehabilitation and AF clinics. Semistructured interviews, broadly guided by the Symptom Experience Model, explored perceptions, evaluations, and responses to AF symptoms. Thematic analysis used a 2-step approach, deductively coding for participants' symptom perceptions, evaluations, and responses and inductively coding within these broader Symptom Experience Model concepts.

Results 

Perception involved awareness of bodily sensations, ranging from imperceptible noticing to commanding attention, heightened by rest and activity. In evaluation, participants used self-derived theories to explain their symptoms, gathered evidence to support/refute their theories, and formulated alternative theories as symptoms changed over time. Responses consisted of nontreatment, self-treatment, and health seeking; most participants needed repeated healthcare visits before diagnosis.

Conclusions 

The current study identified challenges participants experienced in developing awareness of their AF symptoms, the complex cognitive processes associated with evaluation, and barriers that made it difficult to respond to AF symptoms in a timely manner. Understanding the prediagnosis symptom experience from the patient's perspective is essential for the enhancement of current AF screening practices.

中文翻译：

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心房颤动患者初诊前的症状体验。

背景 

心房颤动(AF) 是最常见的心律失常形式，随着年龄的增长，其患病率稳步上升。如果不及时治疗，房颤会显着增加中风、心力衰竭和死亡的风险。尽管患病率不断增加，但在AF 患者的诊断前症状体验方面存在显着的研究空白。

目标 

这项定性描述性研究的目的是探讨AF 患者的诊断前症状体验。

方法 

从心脏康复门诊和 AF 诊所招募了 19 岁或 19 岁以上的前一年诊断为 AF 的参与者（n = 26）。在症状体验模型的广泛指导下，半结构化访谈探讨了对 AF 症状的看法、评估和反应。主题分析使用两步法，对参与者的症状感知、评估和反应进行演绎编码，并在这些更广泛的症状体验模型概念中进行归纳编码。

结果 

知觉涉及对身体感觉的觉察，从难以察觉的注意到引起注意，通过休息和活动而增强。在评估中，参与者使用自我衍生的理论来解释他们的症状，收集证据来支持/反驳他们的理论，并在症状随时间变化时制定替代理论。回应包括不治疗、自我治疗和寻求健康；大多数参与者在诊断前需要多次就诊。

结论 

目前的研究确定了参与者在发展对其 AF 症状的认识方面遇到的挑战、与评估相关的复杂认知过程，以及难以及时对 AF 症状做出反应的障碍。从患者的角度了解诊断前症状体验对于加强当前的 AF 筛查实践至关重要。