{
  "abstract": "Background Atrial fibrillation (AF) is an abnormal heart rhythm that increases risk of severe stroke fivefold. European Society of Cardiology guidelines recommend that risk factor management be a top priority for those with AF. This study aimed to develop theory to underpin successful risk reduction and lifestyle modification for AF.Aim To build a programme theory for an AF risk reduction and lifestyle modification programme.Methods An initial programme theory was developed based on an extensive scoping review and a realist review on integrated AF care, underpinned by the Self-Care of Chronic Illness theory. Sixteen people with AF were recruited via patient support charity Arrythmia Alliance to participate in individual online interviews between February and March 2024. Data were analysed inductively followed by deductive analysis based on the theory. Retroductive reasoning was used to refine the programme theory. NVIVO14 was used to aid analysis.Results Seven context-mechanism and outcome configurations framed within the Self-Care of Chronic Illness middle range theory were developed. These were Self-care maintenance: 1) access to credible information, early support and tailored advice, 2) knowledgeable, proactive healthcare professionals who ensure patients know that exercise is safe and signpost to suitable lifestyle risk factor reduction resources, 3) health ownership created through peer support and comparison of successful lifestyle change; Self-care monitoring: 4) feedback through self-monitoring of heart rate and rhythm and timely feedback from healthcare professionals, 5) self-awareness of what is happening in their bodies; and Self-care management: 6) proactive in own journey and empowered to seek advice and support for lifestyle management, and 7) consistency of message from those providing AF care.Conclusion Patients with AF felt under supported and under prioritised for lifestyle management. We identified patient perspective mechanisms to create an adaptable framework to help design future interventions and increase the likelihood of intervention success.",
  "authors": [
    {
      "affiliations": [
        "Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN"
      ],
      "name": "Alice Pearsons"
    },
    {
      "affiliations": [
        "Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN",
        "Department of Cardiovascular Sciences, University of Leicester, University Rd, Leicester LE1 7RH"
      ],
      "name": "Coral L Hanson"
    },
    {
      "affiliations": [
        "Department of Nursing, Maastricht University Medical Centre, Maastricht, The Netherlands",
        "Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands",
        "Centre for Heart Rhythm Disorders, University of Adelaide and The Royal Adelaide Hospital, Adelaide, Australia"
      ],
      "name": "Jeroen Hendricks"
    },
    {
      "affiliations": [
        "Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN",
        "University of Sydney, Sydney Nursing School, Charles Perkins Centre, Johns Hopkins Road, Sydney, NSW 2006, Australia",
        "Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wroclaw, Poland"
      ],
      "name": "Lis Neubeck"
    }
  ],
  "title": "P37 What mechanism(s) underpin successful risk reduction and lifestyle modification in atrial fibrillation: a realist qualitative study",
  "uid": "b7a68a9f-a6da-5743-85d9-a038549b4a3f"
}