There are in excess of one million people across the UK people living with atrial fibrillation (AF), a long term condition that can lead to stroke and other complications, costing the NHS over £2,200 million per year. However little is known about the experience of living with AF and what patients' perceptions are of the support they receive from health professionals. In order to ensure that patients have the best possible experience of care, healthcare professionals need to have an understanding of how patients view their condition and the type of support they would like to receive from the professionals involved in their care. Although there has been a significant amount of work investigating social support for people with health conditions, there has been little work exploring support provided by healthcare professionals, defined in this study as professional support. This study aimed to investigate and assess the professional support needs of people with AF to develop knowledge and understanding in this field. A theoretical framework for professional support was developed based on the tri-dimensional model of social support and was used to direct the research. Using an exploratory sequential design, a two phase mixed methods study was undertaken. Initially, qualitative interviews were undertaken with patients recruited from outpatient arrhythmia clinics at one National Health Service (NHS) hospital and identified from the perspective of the patient how, when and where healthcare professionals did/did not provide support. Key components of emotional, informational and tangible professional support were identified from thematic analysis of the interview data and used to inform the development of a quantitative questionnaire. Physical activity, exercise and the impact of AF on activity levels were identified by participants as important and so were also included. The quantitative online questionnaire was completed by patient members of the Atrial Fibrillation Association (AFA). To examine relationships between variables, statistical analyses were performed using Fisher's exact test and indicated that people with AF had a range of emotional, informational and tangible professional support needs. Different subgroups of people with AF had different professional support needs: People with more severe symptoms needed more emotional support as well as more tangible support and people with paroxysmal AF needed more informational support. People undergoing ablation as treatment for their AF had specific informational and emotional needs for support. AF played a significant part in the lives of people with AF by modifying activities of daily living and shaping physical activity behaviour and choice of activities. People with AF therefore needed professional support in maintaining and/or increasing their levels of activity. Considering the specificity of professional support, GPs, cardiologists and arrhythmia nurse specialists were identified as most supportive, with GPs and cardiologists also considered as the least helpful at providing support, indicating a variation in professional support. The findings from this study contribute to the limited body of knowledge describing the experience of living with AF and provide healthcare professionals with a unique understanding of how best to provide professional support. The tri-dimensional model provides detailed knowledge of the components of informational, emotional and tangible support that people with AF would like to receive from the healthcare professionals involved in their care. The findings indicate there are differing support needs for different subsets of people with AF demonstrating a need for individualised professional support. The theoretical framework for professional support used in this study provides a model that could be used in future research studies to identify the types of professional support required by patients and to identify subgroups of patients who may require additional professional support. By accurately identifying the needs of patients, this will ensure that healthcare professionals are able to deliver effective patient centred services, leading to an improved patient experience and the delivery of high quality patient care.

Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

Bakgrund: Diabetes är en kronisk sjukdom som drabbar cirka 425 miljoner människor världen över och kan orsaka förtida död. Diabetes Federation rapporterar en ökning av diabetes runtom i världen, främst i låg- och medelinkomstländer. I Sverige drabbas cirka 5% av befolkningen av typ 2-diabetes och siffran fortsätter att öka. Samhället behöver ta ett större ansvar genom att ta på sig en gedigen ledarroll för att bevara människors hälsa och därigenom hjälpa landets invånare att förändra sin livsstil. Behandlingen av diabetes ska inte enbart fokusera på medicinering utan även på andra omvårdnadsinsatser som kan hjälpa patienter med typ 2-diabetes att leva ett så sunt och normalt liv som möjligt. Syfte: Syftet med denna litteraturöversikt är att beskriva stödet i samband med livsstilsförändringar vid typ 2-diabetes. Metod: Metoden utgjordes av en litteraturöversikt som bygger på 12 vetenskapliga artiklar med både kvalitativa och kvantitativa ansatser. Resultat: Resultatet efter dataanalysen visade på två huvudteman varav den ena var Stöd till ändrad livsstil och den andra var Stöd för ökad kunskap och motivation samt sex subteman vilka innefattade nutritionsstöd, stöd för viktnedgång, stöd för ökad aktivitet, stöd från sjukvårdspersonal, kunskapsstöd och socialt stöd. Det som framkom var att individer med diabetes typ 2 påverkades positivt av olika typ av stöd, vilket kan komma att hjälpa individerna att förändra sin livsstil, hindra komplikationer och uppnå en värdig hälsa. Slutsats: Olika former av stöd främjar hälsa och välmående samt ger patienter med typ 2 diabetes en bättre livskvalitet och möjliggör för patienten att leva ett hälsosamt liv. / Background: Diabetes is a chronic disease that affects approximately 425 million people worldwide and can cause premature death. The Diabetes Federation reports an increase in diabetes around the world, mainly in low- and middle-income countries. In Sweden, about 5% of the population suffers from type 2 diabetes and the number continues to increase. Society needs to take on a greater responsibility by assuming a solid leadership role to preserve human health and thereby help the country's inhabitants to change their lifestyle. The treatment of diabetes should not only focus on medication but also on other nursing efforts that can help patients with type 2 diabetes to live as healthy and normal life as possible. Aim: The purpose of this literature review is to describe the support associated with lifestyle changes in type 2 diabetes. Method: The method consisted of a literature review based on 12 scientific articles with both qualitative and quantitative approaches. Results: The results after the data analysis showed two main themes whereas one was related to support for changing one’s lifestyle and the other one was support for increased knowledge and motivation as well as six subthemes which included nutrition support, weight loss support, increased activity support, support from healthcare professionals, knowledge support and social support. What emerged was that individuals with type 2 diabetes were positively affected by different types of support, which may help individuals to change their lifestyle, prevent complications and help them achieve dignified health. Conclusion: Various forms of support promote health and well-being and give patients with type 2 diabetes a better quality of life and enable the patient to live a healthy life.

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