Rebuilding life after heart valve surgery: The VALCAR(E)_QoL study on rehabilitation and quality of life

The VALCAR(E)_QoL study is a prospective, mixed-methods observational investigation designed to characterize the rehabilitation process and determinants of health-related quality of life in patients undergoing cardiac valve surgery. Conducted at the IRCCS Fondazione Don Carlo Gnocchi in Florence (Italy), the study integrates quantitative and qualitative approaches to capture the multidimensional nature of recovery within the International Classification of Functioning, Disability and Health (ICF) framework. Consecutive patients admitted for inpatient cardiac rehabilitation after valve surgery will be assessed at four time points: pre-surgery (T0), rehabilitation admission (T1), discharge (T2), and six-month follow-up (T3). Data collection includes clinical, functional, and psychosocial indicators, as well as patient-reported outcomes such as the Kansas City Cardiomyopathy Questionnaire (primary outcome), SF-12 Health Survey, and standardized measures of anxiety, depression, stress, self-care, and sleep quality. Qualitative interviews at discharge complement quantitative findings by exploring patients' emotional experiences, perceived barriers, and facilitators of recovery. All data are collected in pseudonymized form through a secure REDCap database and analyzed using multivariate and thematic techniques. This protocol adheres to the STROBE guidelines to ensure methodological transparency and reproducibility. By integrating objective measures and subjective experiences, the VALCAR(E)_QoL study aims to identify clinical and psychosocial predictors of successful rehabilitation and to provide evidence for patient-centered, multidisciplinary models of post-surgical care for individuals recovering from heart valve surgery.