ArticleJournal of geriatric cardiology : JGC2017
Conditions for autonomous choice: a qualitative study of older adults' experience of decision-making in TAVR.
Article in Journal of geriatric cardiology : JGC, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Shared decision making and advance care planning: a systematic literature review and novel decision-making model.BMC medical ethics · 2023Pooled it
- Patient values and preferences on valve replacement for aortic stenosis: a systematic review.Heart (British Cardiac Society) · 2021Pooled it
- Medical graphics to improve patient understanding and anxiety in elderly and cognitively impaired patients scheduled for transcatheter aortic valve implantation (TAVI).Clinical research in cardiology : official journal of the German Cardiac Society · 2025Trial
- A Descriptive Qualitative Study of Patient and Carer Perspectives on the Acceptability of Transcatheter Aortic Valve Implantation.Journal of advanced nursing · 2026Article
- 'I am old, and I will rather abandon life with my eyes open': a qualitative study of Norwegians aged 80 and older explaining their intensive care unit admission preferences.Age and ageing · 2025Article
- Qualitative research in cardiac surgery: importance, challenges, and opportunities.Indian journal of thoracic and cardiovascular surgery · 2025Article
- Article
- Exploring different stroke populations' information needs: a cross-sectional study in England.Archives of public health = Archives belges de sante publique · 2024Article
- Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants - a scoping review.BMC medical ethics · 2023Article
- Health Literacy in the Context of Implant Care-Perspectives of (Prospective) Implant Wearers on Individual and Organisational Factors.International journal of environmental research and public health · 2022Article
- What matters most to patients with severe aortic stenosis when choosing treatment? Framing the conversation for shared decision making.PloS one · 2022Article
- A novel geriatric assessment frailty score predicts 2-year mortality after transcatheter aortic valve implantation.European heart journal. Quality of care & clinical outcomes · 2019Observational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement (TAVR).
methodsQualitative study entailing semi-structured interviews of a purposive sample of ten older (range 73-89, median 83.5 years) adults after TAVR (median 23 days). The study setting was a cardiac department at a university hospital performing TAVR since 2010. Analysis was by systematic text condensation.
resultsEven when choice seemed hard or absent, TAVR-patients deliberately took the chance offered them by processing risk assessment, ambivalence and fate. They regarded declining the treatment to be worse than accepting the risk related to the procedure. The experience of being thoroughly advised by their physician formed the basis of an autonomous trust. The trust they felt for the physicians' recommendations mitigated ambivalence about the procedure and risks. TAVR patients expressed feelings consistent with self-empowerment and claimed that it had to be their decision. Even so, choosing the intervention as an obligation to their family or passively accepting it was also reported.
conclusionsOlder TAVR patients' experience of an autonomous decision may encompass frank tradeoff; deliberate physician dependency as well as a resilient self-view. Physicians should be especially aware of how older adults' subtle cognitive declines and inclinations to preserve their identities which can influence their medical decision making when obtaining informed consent. Cardiologists and other providers may also use these insights to develop new strategies that better respond to such inherent complexities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.