Patients' lived experiences and coping mechanisms following mitral valve replacement at the National Cardiac Institute in Tanzania: a qualitative study

坦桑尼亚国家心脏研究所二尖瓣置换术后患者的生活体验和应对机制:一项定性研究

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Abstract

OBJECTIVE: To qualitatively explore patients' lived experiences and coping mechanisms following mitral valve replacement (MVR) at the National Cardiac Institute in Tanzania. DESIGN: A descriptive qualitative study using in-depth interviews and thematic analysis. SETTING: The study was conducted at the National Cardiac Institute, located in Dar es Salaam, the sole tertiary cardiac centre in Tanzania offering open-heart surgery. PARTICIPANTS: 17 participants were purposively sampled. Inclusion criteria were as follows: patients aged ≥18 years, had at least 28 days post-MVR, without chronic conditions (eg, diabetes and HIV) and attending postoperative cardiac clinics. MAIN OUTCOME MEASURES: Semi-structured interviews conducted in May 2024 using an interviewer guide explored post-MVR challenges, daily life adjustments, patient-provider interactions and coping strategies. Thematic analysis was employed to identify key themes. RESULTS: Three primary themes emerged: (1) Quality of life after MVR, encompassing physical, social, economic and psychological challenges; (2) Quality of care after MVR, highlighting patient-provider interactions and access to services; and (3) Adapting to post-MVR life, including psychological adaptation and lifestyle modification. Participants reported improved quality of life through shared experiences and support. CONCLUSION: Patients experienced physical, socio-economic and psychological challenges post-MVR. However, quality of life improved through access to care, peer support and adaptive coping. Adaptation to life with an artificial valve is feasible with robust support systems, even in resource-limited settings.

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