Psychological experiences of patients with Stanford type B aortic dissection during the preoperative waiting period: a qualitative study.

BACKGROUND: Stanford type B aortic dissection (TBAD) is a life-threatening cardiovascular emergency. For patients with acute uncomplicated TBAD, elective thoracic endovascular aortic repair is often preceded by a preoperative waiting period for medical stabilization. During this period, patients face ongoing risks of disease progression while definitive treatment is delayed, creating a distinct context of illness uncertainty. However, the psychological adaptation processes underlying this experience remain insufficiently understood.

OBJECTIVE: This study aimed to explore the psychological experiences of patients with TBAD during the preoperative waiting period, guided by Mishel's Uncertainty in Illness Theory (UIT).

METHODS: A descriptive phenomenological qualitative study was conducted between July and December 2025 at the Cardiac and Vascular Surgery Center of a tertiary hospital in Eastern China. Purposive sampling was used to recruit 17 patients awaiting elective surgery for TBAD. Data were collected through semi-structured, in-depth interviews and analyzed using Colaizzi's seven-step phenomenological method.

RESULTS: The preoperative waiting period was characterized as a dynamic process of psychological adaptation. Four interrelated themes were identified: constructing illness uncertainty, appraisal of the waiting experience, coping strategies, and the dynamics of trust.

CONCLUSION: Patients with TBAD experienced the preoperative waiting period as a complex process shaped by illness uncertainty, meaning appraisal, coping strategies, and trust. These findings extend the application of UIT to the context of delayed intervention for life-threatening cardiovascular disease and highlight the importance of integrated psychosocial support during preoperative waiting. Clear and consistent communication, trust-building, adaptive meaning-focused support, and individualized coping interventions may support psychological adjustment during this vulnerable period.