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Impact of atrial fibrillation, stroke and oral anticoagulation on patients


Project Description

Atrial fibrillation (AF) is common and the majority of patients with AF will require oral anticoagulation to reduce their risk of stroke. Although oral anticoagulation is effective for stroke prevention it is associated with a higher risk of bleeding. In patients with AF who have suffered a stroke caused by a bleed in the brain (intracerebral haemorrhage, ICH), decisions about whether or not to treat them with oral anticoagulation is a medical dilemma as there is currently no robust evidence from randomised clinical trials on the risks or benefits of antithrombotic treatment in this patient group. In this PhD project, we propose a programme of work that investigates the psychological impact of AF and ICH and how patients and physicians make treatment decisions regarding antithrombotic therapy, using a mixed-methods approach.

The project will use mixed methods to investigate the decision-making process of patients with AF and ICH and the physicians who treat them and the psychological impact of AF and ICH on patients. Working alongside colleagues and a Patient Public Involvement (PPI) group, the student would be encouraged to develop topic guides for use with both patients and physicians and to conduct semi-structured interviews. The results will be analysed thematically, using appropriate methodology (i.e., framework analysis), facilitated by Nvivo (as appropriate). In addition, the psychological impact of AF and ICH would be explored using questionnaires and analysed using appropriate statistical methods. Familiarity with statistical software such as SPSS or Stata would be advantageous but training on this will be provided.

Eligibility

Specific requirements of the project:

The successful applicant will have either:
1) An honours degree (2:1 or above) in a subject relevant to the project such as psychology, nursing, medicine, biomedical sciences, or other health-related subject
2) A Masters degree in a subject relevant to the research project
3) A professional qualification related to the project AND appropriate research experience

Previous experience of qualitative research methodology is essential

For candidates whose first language is not English a minimum IELTS score of 6.5 is required, with no element below 6.0.

Enquiries to: Dr Deirdre Lane,

To apply: please send your CV and a covering letter to Dr Deirdre Lane ( ) with a copy to


The Institute of Ageing and Chronic Disease is fully committed to promoting gender equality in all activities. In recruitment we emphasize the supportive nature of the working environment and the flexible family support that the University provides. The Institute holds a silver Athena SWAN award in recognition of on-going commitment to ensuring that the Athena SWAN principles are embedded in its activities and strategic initiatives.

Funding Notes

This studentship is fully funded by the Institute of Ageing and Chronic Disease. It includes fees at UK/EU rates and an annual stipend at UKRI recommended rates, expected to be £14,999 for 2019-20.

References

1. Lip GYH, Banerjee A, Boriani G, Chiang CE, Fargo R, Freedman B, Lane DA, Ruff CT, Turakhia M, Werring D, Patel S, Moores L. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report. Chest. 2018; 154(5):1121-1201. doi: 10.1016/j.chest.2018.07.040.
2. Borg Xuereb C, Shaw RL, Lane DA. Patients' and physicians' experiences of atrial fibrillation consultations and anticoagulation decision-making: A multi-perspective IPA design. Psychol Health. 2016; 31(4):436-55. doi: 10.1080/08870446.2015.1116534
3. Borg Xuereb C, Shaw RL, Lane DA. Patients' and health professionals' views and experiences of atrial fibrillation and oral-anticoagulant therapy: a qualitative meta-synthesis. Patient Educ Couns. 2012; 88(2):330-7. doi: 10.1016/j.pec.2012.05.011.
4. Clarkesmith DE, Lip GYH, Lane DA. Patients' experiences of atrial fibrillation and non-vitamin K antagonist oral anticoagulants (NOACs), and their educational needs: A qualitative study. Thromb Res. 2017;153:19-27. doi: 10.1016/j.thromres.2017.03.002.
5. Mas Dalmau G, Sant Arderiu E, Enfedaque Montes MB, Solà I, Pequeño Saco S, Alonso Coello P. Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation: a qualitative systematic review. BMC Fam Pract. 2017; 18(1):3. doi: 10.1186/s12875-016-0574-0.
6. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P; ESC Scientific Document Group. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38):2893-2962. doi: 10.1093/eurheartj/ehw210.

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