Predictors of quality of life after cardiac procedures: a mixed-methods study.

A total of 1016 patients participated in the cross-sectional survey study following cardiac procedures, divided into two groups based on procedure type.

• 731 patients underwent CABG (coronary artery bypass grafting), PCI (percutaneous coronary intervention), or SAVR (surgical aortic valve replacement), forming the CPS-group.
• 285 patients underwent PVI (pulmonary vein isolation) for atrial fibrillation, forming the PVI-group.
• The study used a stepwise, mixed-methods design combining a literature search, Delphi study, and cross-sectional survey.
• 19 determinants were selected through the literature search and Delphi study and subsequently observed among patients.

In the CPS-group, 9 determinants were associated with significant changes in physical health-related quality of life after cardiac procedures.

• HRQoL was measured with the SF36-2 or SF12-2 questionnaires in the CPS-group.
• Both psychological and social factors were among the significant determinants identified.
• The study examined the impact of 19 pre-selected determinants on HRQoL changes.
• The CPS-group included patients undergoing CABG, PCI, or SAVR.

In the CPS-group, 9 determinants were associated with significant changes in mental health-related quality of life after cardiac procedures.

• Mental HRQoL was assessed using the SF36-2 or SF12-2 questionnaires.
• Psychological and social factors were highlighted as significant predictors for mental HRQoL.
• The number of significant mental HRQoL determinants equaled the number found for physical HRQoL (9 each).
• These findings suggest that mental and physical dimensions of HRQoL are influenced by similarly broad sets of factors.

In the PVI-group, significant determinants were identified across all four domains of the AFEQT (Atrial Fibrillation Effect on QualiTy-of-life) questionnaire.

• The AFEQT questionnaire was used specifically for the PVI (pulmonary vein isolation) group, who had atrial fibrillation.
• Significant determinants were found in each of the four AFEQT domains.
• 285 patients comprised the PVI-group.
• Psychological and social factors were among the significant predictors in this group as well.

Psychological and social factors were identified as significant predictors of HRQoL after cardiac procedures across both patient groups.

• The mixed-methods approach combined literature review, Delphi expert consensus, and patient survey to identify and validate determinants.
• 19 determinants in total were selected for examination, encompassing psychological, social, and other domains.
• The findings applied across both the CPS-group (CABG, PCI, SAVR) and the PVI-group.
• The authors note that 'several psychological and social factors are significant predictors for patients' HRQoL after cardiac procedures.'

The study concludes that addressing psychological and social determinants in clinical consultations may support shared decision-making and help optimize treatment choices for individual patients.

• The authors state that 'addressing these factors in consultations is considered important when deciding about cardiac procedures.'
• The findings are linked to potential benefits for shared decision-making and management of patient expectations.
• The study suggests these factors may be 'beneficial for choosing the most optimal treatment choice for the individual patient.'
• Changes in HRQoL were framed as tools for both evaluating quality of care and enhancing shared decision-making.

Relevant determinants for HRQoL changes were identified through a combined literature search and Delphi study before patient data collection.

• The Delphi study involved expert consensus to select the most relevant determinants from those found in the literature.
• 19 determinants were ultimately selected through this process.
• This stepwise approach was designed to ensure clinical and scientific relevance of the determinants examined.
• The Delphi method is a structured expert consultation technique used to achieve consensus on complex topics.