Premium
Adapting to living with a mechanical aortic heart valve: a phenomenographic study
Author(s) -
Oterhals Kjersti,
Fridlund Bengt,
Nordrehaug Jan Erik,
Haaverstad Rune,
Norekvål Tone M.
Publication year - 2013
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12076
Subject(s) - medicine , mechanical valve , mechanical heart valve , aortic valve , life expectancy , warfarin , prosthesis , aortic valve replacement , mechanical heart , heart valve , surgery , stenosis , atrial fibrillation , population , environmental health
Aim To describe how patients adapt to living with a mechanical aortic heart valve. Background Aortic valve replacement with a mechanical prosthesis is preferred for patients with life expectancy of more than 10 years as they are more durable than bioprosthetic valves. Mechanical valves have some disadvantages, such as higher risk of thrombosis and embolism, increased risk of bleeding related to lifelong oral anticoagulation treatment and noise from the valve. Design An explorative design with a phenomenographic approach was employed. Methods An explorative design with a phenomenographic approach was applied. Interviews were conducted over 4 months during 2010–2011 with 20 strategically sampled patients, aged 24–74 years having undergone aortic valve replacement with mechanical prosthesis during the last 10 years. Findings Patients adapted to living with a mechanical aortic heart valve in four ways: ‘The competent patient’ wanted to stay in control of his/her life. ‘The adjusted patient’ considered the implications of having a mechanical aortic valve as part of his/her daily life. ‘The unaware patient’ was not aware of warfarin–diet–medication interactions. ‘The worried patient’ was bothered with the oral anticoagulation and annoyed by the sound of the valve. Patients moved between the different ways of adapting. Conclusions The oral anticoagulation therapy was considered the most troublesome consequence, but also the sound of the valve was difficult to accept. Patient counselling and adequate follow‐up can make patients with mechanical aortic heart valves more confident and competent to manage their own health. We recommend that patients should participate in a rehabilitation programme following cardiac surgery.