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

Aims. To explore the structure and content of narratives about the recoveryprocess among patients undergoing heart valve surgery participating in cardiacrehabilitation.Background. Several studies with short-term follow-up have shown that recoveringfrom cardiac surgery can be challenging, but evidence on the long-term recoveryprocess is very limited, especially following heart valve surgery. Furthermore, fewstudies 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). Werecruited nine patients undergoing heart valve surgery from a randomized trial,CopenHeartVRand 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 tonormality. The analysis identified four courses of recovery, with three non-linearcomplex pathways deviating from the classic restitution narrative: the frustratedstruggle to resume normality, the challenged expectation of normality – being in alimbo and becoming a heart patient. These deviating pathways were characterizedby physical, existential and mental challenges even up to 9 months after surgery.Conclusion. The recovery processes of participants’ in cardiac rehabilitation wereoften more complicated than anticipated. Patients undergoing heart valve surgerymay benefit from more extensive medical follow-up immediately after discharge,individual psychological assessment and individualized, realistic informationabout the recovery trajectory.