Experiences of warfarin use among cardiac valve-replaced patients in Iran

One of the most common cardiac surgeries is valve replacement. All cardiac valve-replaced patients need to use warfarin during their life in order to reduce the risk of valvular thrombosis. There were some reports about various problems of using warfarin by considering care conditions، but there was no comprehensive study based on patients’ experiences. The present study was carried out with the aim of explaining the experiences of cardiac valve-replaced patients about using warfarin. This study was conducted with a qualitativeresearch approachand conventional content analysis in 2013. The Participants were 10 cardiac valve-replaced patients who had experiences of different time periods in Tehran and Kashan therapeutic centers and outpatients who had the experience of living with metal cardiac valves. Data collection was performed through semi-structured interview and purposive sampling and it continued until data saturation. Data analysis had been done continually and concurrently with data collection and it was performed through a comparative method. 479 codes were extracted from deep and rich descriptions of the participants. There were two main themes during data analysis process including: concern and fear of changes in the International Normalized Ratio (INR) and the struggle for the correct use of warfarin and adjustment of INR، the first theme was fear and concern about warfarin use which was consisted of five subcategories; concern on the correct use of warfarin; concern on health cares، warfarin side effects; concern on pregnancy and dental care، the second theme was effort for correct use of warfarin and regulating its use which was consisted of five subcategories: perceiving the necessity of warfarin use، adherence to the physician، self-care، physicians’ recommendations and health care and educational requirements for warfarin use. Cardiac valve-replaced patients have a permanent fear and concern during thetime of warfarin use and they try to reduce it with the correct use of warfarin and the adjustment of INR. It is necessary to help them to reduce such concerns through actual knowledge of the patients، providing post-discharge care and establishing the society for cardiac valve-replaced patients and the family.