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To provide a structured analysis of the acceptability of transcatheter aortic valve implantation to support clinical conversations, decision making and recovery for older adults with aortic stenosis and their carers.
While transcatheter aortic valve implantation is an effective treatment for heart valve disease, its acceptability to patients and caregivers remains unclear. Understanding the acceptability of clinical procedures is key for influencing patient engagement in self-care and guiding the information and support patients and carers need.
A descriptive, qualitative study used deductive content analysis, guided by Sekhon's Theoretical Framework of Acceptability.
Participants included 18 aortic stenosis patients (mean age 84.2 ± 4.1 years) and 8 carers from three Australian metropolitan hospitals (2018–2020). Semi-structured interviews were conducted 4–6 months post–TAVI and transcribed verbatim. Analysis used Sekhon's Theoretical Framework of Acceptability across three temporal zones, with deductive coding examining affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy.
Participants described high prospective, concurrent and retrospective acceptability of transcatheter aortic valve implantation. Perceived prospective acceptability framed the procedure as lifesaving. Peri-operatively, participants found the procedure simple, low-risk and minimally disruptive, ensuring high concurrent acceptability. Post-procedure, patient participants described a slow but gradual return to normal, growing confidence and a reengagement with their valued pastimes. The absence of structured rehabilitation advice led to self-designed recoveries and uncertainty about safe limits.
Transcatheter aortic valve implantation was perceived as a highly acceptable intervention that helped this group of mostly older adults achieve their personal goals.
Despite the minimally invasive nature of transcatheter aortic valve replacement, optimising recovery and rehabilitation requires a holistic approach that addresses both clinical needs and patient goals.
None in the conceptualisation or design.
To understand, from a nursing perspective, factors affecting the use of prophylactic dressings to prevent pressure injuries in acute hospitalised adults.
Pressure injury causes harm to patients and incurs significant costs to health services. Significant emphasis is placed on their prevention. Relatively recently, prophylactic dressings have been promoted to reduce pressure injury development. However, in the acute care setting, information about the clinical use of these dressing is lacking.
Qualitative, descriptive.
Nineteen medical and surgical nurses participated. Semi-structured interviews were conducted and transcribed verbatim. Thematic analysis was performed using an inductive approach using NVivo software.
Three themes were identified, reflecting factors that influenced and perpetuated indiscriminate use of prophylactic dressings: False sense of security; Convenience and task prioritisation; and Navigating challenges in evidence-based pressure injury prevention.
The findings indicate inconsistent prevention practices, with prophylactic dressings often applied without justification or referral to research-based evidence to guide clinical decision-making. There was a prevailing attitude of ‘job done’ when a prophylactic dressing was applied.
This study has identified several factors that perpetuate the inappropriate use of prophylactic dressings for pressure injury prevention that may be amenable to organisational change. The findings indicate that nurses often rely on these dressings as a shortcut due to time constraints, which led to missed skin assessments and low-value care. The research can be used to inform the development of clear guidelines on dressings within hospital settings which encourage assessment-based selection for their use, and process-based guidance for their application, skin surveillance, dressing inspection and removal.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guideline was followed.
Neither patients nor the public were directly involved in this study.
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