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

Joren J. Burger, Connie van Bemmel, Deborah Keukens, Roelie Pomstra, Philip J. van der Wees, Niek Koenders
Purpose:

To gain a comprehensive understanding of experiences related to being physically active in participants with an uncomplicated, conservatively managed, type B aortic dissection.

Methods:

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. Patient representatives were part of the research team and contributed to formulating the research question, creating the study design, conducting the data analysis, and reporting findings.

Results:

We collected, in total, 644 minutes interview data from 14 participants. We found three patterns in the data. First, participants told us that they were losing confidence in their body. For example, a participant said: “It felt like I could not rely 100% on my body anymore.” Second, participants indicated that confidence in their body was regaining with expressions such as: “I had to regain confidence in my body. I was trying to move, however, without risking too much.” Third, participants told us that they were continuing to build confidence in their body. For example, a participant said: “I was gaining experiences and continuing to build confidence in my body by trial-and-error.”

Conclusion(s):

Adults with an uncomplicated type B aortic dissection experience that their self-confidence related to being physically active changes immediately after the diagnosis of the aortic dissection. Supportive coping strategies, according to the participants, are accepting risks, recognizing the necessity of physical activity, and exploring exercise limits. Rehabilitation professionals should support adults regaining and continuing to build self-confidence with exercise-based cardiac rehabilitation. These programs provide opportunities for patients to find the perfect balance between blood pressure regulation, quality of life, and being physically active. It may be tempting for rehabilitation professionals to keep safe margins and opt for a strict blood pressure regulation; however, this should not be exaggerated at the expense of quality of life and exercise tolerance.

Implications:

1. 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

2. 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)

3. Rehabilitation professionals should help adults with an uncomplicated type B aortic dissection to explore, push and, ultimately, accept limits related to exercise tolerance



Funding acknowledgements:
The authors did not receive a specific grant for this research from any funding agency.
Keywords:
Physical activity
Cardiac rehabilitation
Qualitative research
Primary topic:
Disability and rehabilitation
Second topic:
Cardiorespiratory
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Radboud University Medical Center ethical committee.
Provide the ethics approval number:
Ethics approval number 2023-16155.
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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