Mechanical Heart Valve Surgery Patients\u2019 Experience with Warfarin: A Qualitative Study

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Kankaya E. A., Bilik Ö.

CYPRUS JOURNAL OF MEDICAL SCIENCES, vol.7, no.4, pp.470-476, 2022 (Peer-Reviewed Journal)


BACKGROUND/AIMS: This study examined mechanical heart valve surgery (HVS) patients’ experiences with warfarin. Although warfarin therapy is of vital importance for heart valve patients, the lack of therapeutic international normalized ratio (INR) levels in long-term anticoagulant therapy can cause various complications. MATERIALS AND METHODS: This qualitative study was carried out as phenomenological. The sample included 12 first time HVS patients who received anticoagulant treatment for at least three months after discharge. Codes were put together for the purpose of this study and classified. Themes were created. RESULTS: The mean age of the patients was 50.83±12.91 years, and 66.7% (n=8) of them were male. Their mean exposure time to warfarin was 70.50±49.93 months. Content analysis identified four main themes: “difficulties, facilitators, dependence and the impact of side effects from warfarin”. Even those patients who had been using warfarin for many years still suffered from different problems. A lack of knowledge and information about warfarin use still exists. Some patients considered using warfarin as a part of their life, considering it to be more manageable when they agreed to use warfarin, and some said that they continue using warfarin with the support of their relatives and health professionals. Since this study was carried out in the Aegean region, patients had difficulties in limiting greens. The patients mentioned their dependence on the hospital because they had no INR measuring instruments. Some patients explained that they feared the side effects of the drugs, and avoided using other medications. CONCLUSION: HVS patients had problems adhering to warfarin after discharge. They need follow-up and guidance from nurses. Keywords: Heart valve diseases, adherence, outpatients, surgical procedures, warfarin