Objective To explore the trajectory differences of postoperative self-perceived burden among patients treated with different types of heart valve replacement surgery, and analyze its influencing factors.

Methods A convenience sampling method was used to select 200 valvular heart disease patients treated with heart valve replacement surgery. The patients were investigated using a general information questionnaire and Self-Perceived Burden Scale. In addition, the self-perceived burden levels were tracked at discharge and at 1, 3 and 6 months after discharge. The latent class growth model (LCGM) was employed to identify postoperative self-perceived burden subtypes, and a decision tree model was used to analyze the core factors influencing these subtypes.

Results A total of 175 patients completed the follow-up, with a follow-up completion rate of 87.50%. The self-perceived burden of patients treated with cardiac valve replacement surgery from discharge to 6 months after discharge were divided into two change trajectories: the low-burden-continuously increasing group (29.14%) and high-burden - continuously decreasing group (70.86%). According to the contribution degree of predictor variables at each node of the decision tree to the model, the score of awareness of cardiac rehabilitation information importance was the highest (51%), and it was located at the root node, belonging to the most important core influencing factor affecting the trajectory of self-perceived burden. The others in order were the educational level (19%), preoperative NYHA classification (13%), primary caregiver (9%) and postoperative complications (8%). The classification accuracy rate of the model was 97.7%.

Conclusions There is group heterogeneity in the postoperative self-perceived burden of patients undergoing cardiac valve replacement surgery. The score of awareness of cardiac rehabilitation information is the core influencing factor. Medical staff can reduce the self-perceived burden of patients by early identification of high-risk patients with low burden and continuous increase, and formulate intervention plans centered on improving the score of awareness of cardiac rehabilitation information.