The COVID-19 pandemic continues to significantly impact the treatment of people living with aortic stenosis, and access to transcatheter aortic valve implantation. Transcatheter aortic valve implantation (TAVI) programmes require unique coordinated processes that are currently experiencing multiple disruptions and are guided by rapidly evolving protocols. We present a series of recommendations for TAVI programmes to adapt to the new demands, based on recent evidence and the international expertise of nurse leaders and collaborators in this field. Although recommended in most guidelines, the uptake of the role of the TAVI programme nurse is uneven across international regions. COVID-19 is further highlighting why a nurse-led central point of coordination and communication is a vital asset for patients and programmes. We propose an alternative streamlined evaluation pathway to minimize patients’ pre-procedure exposure to the hospital environment while ensuring appropriate treatment decision and shared decision-making. The competing demands created by COVID-19 require vigilant wait list management, with risk stratification, telephone surveillance and optimized triage and prioritization. A minimalist approach with close scrutiny of all parts of the procedure has become an imperative to avoid any complications and ensure patients’ accelerated recovery. Lastly, we outline a nurse-led protocol of rapid mobilization and reconditioning as an effective strategy to facilitate safe next-day discharge home. As the pandemic abates, TAVI programmes must facilitate access to care without compromising patient safety, enable hospitals to manage the competing demands created by COVID-19 and establish new processes to support patients living with valvular heart disease.

Aim and objectives:To explore patients' lived experiences of daily life and coping with recovery after transcatheter aortic valve implantation (TAVI).Background: Transcatheter aortic valve implantation is increasingly used to treat older patients with severe aortic stenosis with high surgical risk. This novel treatment has been shown to be effective in relieving symptoms, improving survival and prognosis, but its impact on patients' daily life has been sparsely explored. Design: Qualitative design.Methods: Qualitative interviews were conducted in a purposeful sample of ten patients three-four months after TAVI. A phenomenological hermeneutical approach comprised an epistemological stance and Ricoeur's work inspired the qualitative methodological foundation. The study adhered to the COREQ guidelines.Results: This study is illuminating patients' perception of recovery after TAVI. The patients experienced a transformation of bodily sensations, a changed bodily attention and enhanced physical possibilities to cope with life. Undergoing TAVI changed the pre-treatment symptoms that limited daily activities, allowing the patients to resume or participate in activities that were previously impossible. TAVI gives patients the feeling that they can do more than before, which strengthens their faith in the body's possibilities and means that they can live a more self-reliant and independent life. Conclusion:For older patients, TAVI can serve to bolster a sense of trusting their own body again. A clear distinction between pre-and post-TAVI is recognised.Patients may be able to resume everyday activities following TAVI. The recovery process, however, must take into account the individual patient's own resources.Relevance to clinical practice: The impact of TAVI on daily life activities should be communicated to the patient in decision-making. Recovery depends on the patient's own effort, why identification of the patients who need support for recovery after TAVI as well as differentiated rehabilitation is required. Walking as a parameter should be integrated in the recovery trajectory. K E Y W O R D S aged, aortic stenosis, patient experience, qualitative research, recovery, Ricoeur, transcatheter aortic valve implantation (TAVI) SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Kirk BH, De Backer O, Missel M.Transforming the experience of aortic valve disease in older patients: A qualitative study.

No abstract

Background: Patients hospitalized with Infective Endocarditis have a complex and a prolonged illness. As part of the rehabilitation, these patients are interviewed a week and one month after discharge. There is currently no litterature concerning medical problems about patients experience after discharge. At present, the outpatient interviews contain an uneven content and quality of the interview seems to be dependent upon the person interviewing. Systematic documentation of patients' experience of health is often poor after the outpatient clinical interviews. Aim: To investigate whether patients 'health status can be described using the SF-36 questionnaire at the outpatient clinical interviews and whether patients' health experiences are basic for nursing assessment and patients' rehabilitation. Method: Pilot testing is used to examine whether SF-36 may be used in the outpatient clinical interviews where patients completed questionnaire is basis of the dialogue. SF-36 includes the scales of Physical Functioning, Role-Physical, Bodily pain, general health, vitality, social functioning, role-emotional and mental health. Applicability assessed by observational study of 6 interviews. Results: All patients' self-rated health is affected by Infective Endocarditis. The questionnaire assessed relevant both by patients and nurses. 7 out of 8 scales from SF-36 recovered and were elaborated in interviews. 'Return to work' and 'relatives' response to illness' are themes which arise. Generally, it is estimated that the questionnaire together with the following interview helps to identify, qualify and systematize the patients' individual experiences as basic for future nursing interventions. Conclusion: SF-36 is suitable to discover patient health experience through the outpatient nursing interviews, but the questionnaire should be followed by focused and detailed questions to promote individual rehabilitation.