Investigation of the effects of individual counseling on anticoagulant treatment compliance, self-efficacy level and quality of life in patients undergoing cardiac valve surgery

We aimed to examine the effect of individual counseling on adherence to anticoagulant therapy, self-efficacy and quality of life in patients who underwent heart valve surgery. It was a two-stage study. The first stage is qualitative; in the second stage is semi-experimental. Twelve patients who underwent heart valve surgery in the first stage and at least three months after discharge constituted the study sample. In-depth interviews were conducted with the patients using a semi-structured interview form. The patient statements were divided into themes by content analysis. In the second stage, 60 patients (control group n=30; intervention group n=30), who were scheduled for heart valve surgery and had mechanical valve prosthesis, constituted the sample. Data were collected using the Quality of Life Scale, the Anticoagulant Treatment Compliance Scale, and the Self-efficacy Expectancy Scale before discharge and three months after surgery. Content analysis performed in the first stage, four main themes were determined: difficulties, facilitators, addiction and side effects. Even patients using warfarin for many years had different problems and there was a lack of information on warfarin use. In the second stage, there was no difference between the sub-dimensions of the quality of life scale before discharge according to the counseling status of the patients. It was determined that the mean scores of the patients who received counseling were significantly higher both before discharge and at the third postoperative month in the subscales of the expectation of self-efficacy scale (p<0,05). Anticoagulant treatment adherence scores was significantly higher in the intervention group. It was observed that the postoperative follow-up of the patients increases the level of self-efficacy and treatment adherence. It is recommended to provide individualized trainings specific to patients before heart valve prostheses, to repeat the trainings and to differentiate the contents by considering the characteristics of the patient.