Shared decision-making plays an important role in ensuring value-based healthcare in cardiac surgery. However, the personal situations of patients in cardiac care have not been widely explored, and thus, little is known about the decision-making experiences of patients and their relatives before surgery. To explore the perceptions of patients indicated for cardiac surgery and their relatives during the decision-making process, as well as their experiences of a conversation aimed at achieving shared decision-making in the treatment trajectory. The data were collected through semi-structured in-depth interviews with patients aged ≥70 years who were indicated for cardiac surgery and their relatives until theme saturation. Both inductive and deductive analysis were conducted based on the principles of reflexive thematic analysis. Interviews with 16 patients and 10 relatives provided in-depth insights into the experiences of patients and their relatives in terms of a shared decision-making process prior to surgery. Overall, 15 subthemes were identified, and these were divided into three themes. In general, the patients’ experiences and perceptions were influenced by their (1) general daily functioning. The relatives were more concerned about (2) social expectations and (3) existential uncertainty. Patients eligible for cardiac surgery and their families have unique experiences and perceptions during the process of shared decision-making. The subthemes emerging from this study, such as the overestimation of potential medical outcomes by patients and their relatives, who experience fear about the current health situation of their loved one, require careful attention from healthcare professionals during decision-making conversations.

中文翻译：

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对老年患者和亲属在心脏手术前的经历和看法的定性研究

共同决策在确保心脏手术中基于价值的医疗保健方面发挥着重要作用。然而，心脏护理中患者的个人情况尚未得到广泛探讨，因此，人们对患者及其亲属在手术前的决策经历知之甚少。探讨接受心脏手术的患者及其亲属在决策过程中的看法，以及他们在治疗轨迹中旨在实现共同决策的对话经历。数据是通过对年龄≥70岁、适合进行心脏手术的患者及其亲属进行半结构化深度访谈收集的，直至主题饱和。归纳分析和演绎分析都是基于反思性主题分析的原则进行的。对 16 名患者和 10 名亲属的采访深入了解了患者及其亲属在手术前共同决策过程中的经历。总体而言，确定了 15 个子主题，并分为三个主题。一般来说，患者的经历和看法受到他们（1）一般日常功能的影响。亲属更关心（2）社会期望和（3）存在的不确定性。适合心脏手术的患者及其家属在共同决策的过程中有着独特的经历和看法。这项研究中出现的次主题，例如患者及其亲属对亲人当前健康状况感到恐惧的潜在医疗结果的高估，需要医疗保健专业人员在决策对话中予以仔细关注。