Losing, regaining, and continuing to build self-confidence – a qualitative, phenomenological study of being physically active with a type B aortic dissection

To gain a comprehensive understanding of experiences related to being physically active in participants with an uncomplicated type B aortic dissection.
We performed a qualitative, phenomenological study. First-person accounts of adults, who at least one year ago had an uncomplicated type B aortic dissection, were collected using semi-structured interviews. The audio recordings of the interviews were transcribed verbatim and analyzed with interpretative phenomenological analysis.
We collected, in total, 644 min interview data from 14 participants. Three patterns were interpreted: losing self-confidence, regaining self-confidence, and continuing to build self-confidence. Experiencing symptoms when pushing limits, challenges with energy management, and side effects of medication caused loss of self-confidence. Changes in identity, reaching milestones that reflect improvement, and support from others and tools helped participants regain self-confidence. To continuing to build self-confidence, participants indicated they needed success experiences and activities make life worth living.
Self-confidence in adults with an uncomplicated type B aortic dissection changes immediately after the diagnosis of the aortic dissection. Rehabilitation professionals can support adults regaining and continuing to build self-confidence, aiming for the perfect balance between blood pressure regulation, quality of life, and being physically active.
Implications for rehabilitation
Rehabilitation professionals should support regaining and continuing to build self-confidence related to being physically active in adults with type B aortic dissection in the early stages of recovery and beyond.
Adults with an uncomplicated type B aortic dissection want rehabilitation professionals to tell them primarily what is possible (recommendations) rather than what is not allowed (rules).
Rehabilitation professionals should help adults with an uncomplicated type B aortic dissection to explore, push and, ultimately, accept limits related to exercise tolerance.

Rehabilitation professionals should support regaining and continuing to build self-confidence related to being physically active in adults with type B aortic dissection in the early stages of recovery and beyond.
Adults with an uncomplicated type B aortic dissection want rehabilitation professionals to tell them primarily what is possible (recommendations) rather than what is not allowed (rules).
Rehabilitation professionals should help adults with an uncomplicated type B aortic dissection to explore, push and, ultimately, accept limits related to exercise tolerance.

为全面了解单纯性B型主动脉夹层（uncomplicated type B aortic dissection）患者参与体力活动的相关体验，本研究采用质性现象学研究方法。通过半结构化访谈收集了至少1年前确诊该疾病的成年受试者的第一人称自述，访谈音频经逐字转录后，采用解释现象学分析（interpretative phenomenological analysis）开展数据分析。

本研究共纳入14名受试者，累计收集总时长644分钟的访谈数据。最终归纳出三类核心模式：自信心丧失、自信心重建与自信心持续构建。受试者在突破运动极限时出现不适症状、精力管理困境以及药物副作用，均会导致自信心受损；身份认知转变、达成体现康复进展的里程碑事件、他人支持与辅助工具，则有助于重建患者的自信心。而对于持续构建自信心而言，受试者表示需要获得成功体验与赋予生活意义的活动。

单纯性B型主动脉夹层成年患者的自信心在确诊后即刻发生变化。康复专业人员可协助患者重建并持续维持自信心，以实现血压调控、生活质量与体力活动三者间的最优平衡。

### 康复领域启示
康复专业人员应在成人B型主动脉夹层患者的康复早期及后续阶段，协助其构建与体力活动相关的自信心并持续维持该状态。
单纯性B型主动脉夹层成年患者更希望康复专业人员优先告知其可行的活动建议，而非限定禁忌规则。
康复专业人员应协助单纯性B型主动脉夹层成年患者探索、突破并最终接受与运动耐量相关的极限阈值。

康复专业人员应在成人B型主动脉夹层患者的康复早期及后续阶段，协助其构建与体力活动相关的自信心并持续维持该状态。
单纯性B型主动脉夹层成年患者更希望康复专业人员优先告知其可行的活动建议，而非限定禁忌规则。
康复专业人员应协助单纯性B型主动脉夹层成年患者探索、突破并最终接受与运动耐量相关的极限阈值。