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J Adv Nurs. 2016 May;72(5):1097-108. doi: 10.1111/jan.12904. Epub 2016 Jan 22.

Cardiac rehabilitation patients' perspectives on the recovery following heart valve surgery: a narrative analysis.

Author information

1
Department of Cardiology, Roskilde Hospital, Denmark.
2
National Centre of Rehabilitation and Palliation, University of Southern Denmark.
3
The Heart Centre, Department of Cardiology, Rigshospitalet, Denmark.
4
Institute of Public Health, University of Southern Denmark, Odense, Denmark.

Abstract

AIMS:

To explore the structure and content of narratives about the recovery process among patients undergoing heart valve surgery participating in cardiac rehabilitation.

BACKGROUND:

Several studies with short-term follow-up have shown that recovering from cardiac surgery can be challenging, but evidence on the long-term recovery process is very limited, especially following heart valve surgery. Furthermore, few studies have explored the recovery process among cardiac rehabilitation participants.

DESIGN:

A qualitative study with serial interviews analysed using narrative methods.

METHODS:

We collected data over 18 months (April 2013-October 2014). We recruited nine patients undergoing heart valve surgery from a randomized trial, CopenHeartVR and conducted 27 individual narrative interviews at 2-3 weeks, 3-4 months and 8-9 months after surgery.

FINDINGS:

Following heart valve surgery, the participants expected to return to normality. The analysis identified four courses of recovery, with three non-linear complex pathways deviating from the classic restitution narrative: the frustrated struggle to resume normality, the challenged expectation of normality - being in a limbo and becoming a heart patient. These deviating pathways were characterized by physical, existential and mental challenges even up to 9 months after surgery.

CONCLUSION:

The recovery processes of participants' in cardiac rehabilitation were often more complicated than anticipated. Patients undergoing heart valve surgery may benefit from more extensive medical follow-up immediately after discharge, individual psychological assessment and individualized, realistic information about the recovery trajectory.

KEYWORDS:

cardiac rehabilitation; heart valve surgery; narrative analysis; nursing; patient experience; recovery

PMID:
26799453
DOI:
10.1111/jan.12904
[Indexed for MEDLINE]

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