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Adapting to living with a mechanical aortic heart valve: a phenomenographic study
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
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2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 9, p. 2088-2098Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2013. Vol. 69, no 9, p. 2088-2098
Keywords [en]
adaptation, aortic stenosis, cardiac nursing, mechanical prosthesis, phenomenographic analysis, qualitative method
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-22670DOI: 10.1111/jan.12076ISI: 000323072200020PubMedID: 23294437Scopus ID: 2-s2.0-84882270515Local ID: HHJADULTISOAI: oai:DiVA.org:hj-22670DiVA, id: diva2:678591
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2018-03-16Bibliographically approved

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