{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:18:12Z","timestamp":1767896292159,"version":"3.49.0"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To qualitatively explore patients\u2019 lived experiences and coping mechanisms following mitral valve replacement (MVR) at the National Cardiac Institute in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive qualitative study using in-depth interviews and thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>17 participants were purposively sampled. Inclusion criteria were as follows: patients aged \u226518 years, had at least 28 days post-MVR, without chronic conditions (eg, diabetes and HIV) and attending postoperative cardiac clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three primary themes emerged: (1)\n                      <jats:italic>Quality of life after MVR<\/jats:italic>\n                      , encompassing physical, social, economic and psychological challenges; (2)\n                      <jats:italic>Quality of care after MVR<\/jats:italic>\n                      , highlighting patient-provider interactions and access to services; and (3)\n                      <jats:italic>Adapting to post-MVR life<\/jats:italic>\n                      , including psychological adaptation and lifestyle modification. Participants reported improved quality of life through shared experiences and support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107455","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T13:40:35Z","timestamp":1767879635000},"page":"e107455","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Patients\u2019 lived experiences and coping mechanisms following mitral valve replacement at the National Cardiac Institute in Tanzania: a qualitative study"],"prefix":"10.1136","volume":"16","author":[{"given":"Jinasa Peter","family":"Kisangija","sequence":"first","affiliation":[{"name":"Nursing Services, Benjamin Mkapa Hospital, Dodoma, Tanzania, United Republic of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4841-0191","authenticated-orcid":false,"given":"Salome E","family":"Buluba","sequence":"additional","affiliation":[{"name":"Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-1134","authenticated-orcid":false,"given":"Menti Lastone","family":"Ndile","sequence":"additional","affiliation":[{"name":"Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"2026010805401722000_16.1.e107455.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.001"},{"key":"2026010805401722000_16.1.e107455.2","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1161\/CIRCULATIONAHA.123.065717","article-title":"Cardiovascular Health Care in Low- and Middle-Income Countries","volume":"149","author":"Mocumbi","year":"2024","journal-title":"Circulation"},{"key":"2026010805401722000_16.1.e107455.3","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001052"},{"key":"2026010805401722000_16.1.e107455.4","unstructured":"World Health Organization . 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