AIM: Postoperative recovery after heart valve surgery is an important topic in the realm of nursing care. This study aimed to evaluate the effect of individualized positioning care on cardiac function recovery and comfort in patients after heart valve surgery.

METHODS: A single-center, retrospective cohort study was conducted, continuously enrolling patients who underwent heart valve surgery at Affiliated Hospital of Xuzhou Medical University from June 2022 to June 2025. A total of 150 patients were included. The patients were divided into a control group (conventional positioning care, n = 76) and an experimental group (individualized positioning care, n = 74) according to the nursing method received. The primary outcome measures were changes in cardiac function indicators, such as left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after nursing, as well as postoperative comfort scores measured using the Visual Analog Scale for Comfort (VAS-Comfort). Secondary outcomes included postoperative pain scores (Numeric Rating Scale [NRS]), sleep quality (Richards–Campbell Sleep Questionnaire [RCSQ]), pulmonary complications, pressure ulcer incidence, intensive care unit (ICU) length of stay, and postoperative hospital days. Group comparisons were performed using t-test, Mann–Whitney U test, Chi-square test, or Fisher’s exact test. Postoperative NT-proBNP was analyzed using analysis of covariance (ANCOVA), adjusting for baseline levels.

RESULTS: Baseline characteristics were balanced and comparable between the two groups (all p > 0.05). Compared to the control group receiving conventional care, the experimental group receiving individualized positioning care showed more significant improvement in cardiac function: the change in LVEF (ΔLVEF) was significantly higher in the experimental group (0.85 ± 3.98% vs. –3.15 ± 4.20%, p < 0.001); NT-proBNP levels on postoperative day 7 were significantly lower in the experimental group (median: 685.00 pg/mL vs. 1003.50 pg/mL, p < 0.001), and the difference remained statistically significant after adjusting for preoperative values (F = 12.13, p < 0.001). The VAS-Comfort score at 72 h postoperatively was significantly higher in the experimental group (p < 0.001). For secondary outcomes, the experimental group had significantly lower NRS pain scores at 72 h postoperatively (p < 0.001), significantly higher RCSQ sleep scores (69.26 ± 9.87 vs. 59.86 ± 12.02, p < 0.001), a lower incidence of pulmonary complications (9.46% vs. 23.68%, p = 0.019), and significantly shorter ICU stay and postoperative hospital days (both p < 0.001). There were no statistically significant differences between the two groups in the incidence of pressure ulcers or adverse events (p > 0.05).

CONCLUSIONS: Individualized positioning care can significantly promote cardiac function recovery, enhance comfort, and improve clinical outcomes in patients after heart valve surgery without increasing safety risks.