Considering Cognition: How Healthcare Professionals Navigate Shared Treatment Decision-Making with Patients with Aortic Stenosis

Abstract

Aortic stenosis (AS) is a cardiac condition that requires complex treatment decisions, particularly in older adults who may have cognitive impairment. Shared decision-making (SDM) is a collaborative process between healthcare professionals (HCPs). This thesis aimed to explore how HCPs consider cognition in SDM with patients with AS and their families. I conducted a secondary qualitative analysis using an interpretive description approach guided by the Interprofessional SDM Model and the Cognitive Continuum Theory. Four qualitative themes emerged: 1) Focus on cognition as a complication, not a comorbidity, 2) Cognitive expertise is sought on-demand, not part of the established heart teams, 3) Family members as a source of insight into cognition and SDM, and 4) Nursing expertise in detection of cognitive changes. Findings highlight gaps in integrating cognition into AS treatment decisions and can inform interventions to improve the care of people with AS.