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.