The lived experience of abdominal aortic aneurysm (AAA): A qualitative systematic review

Abstract

Objective To synthesise qualitative evidence on the lived experiences of screening, diagnosis, surveillance, and management among individuals with abdominal aortic aneurysm (AAA). Data sources AMED, CINAHL, Cochrane Library, Embase, PsycINFO, and PubMed were searched from inception to January 2025, supplemented by manual reference checks. Review methods Eligible studies reported primary qualitative data on the experiences of people living with AAA. Two reviewers independently screened titles, abstracts, and full texts, and assessed methodological quality using the Critical Appraisal Skills Programme (CASP) checklist. Data were synthesised using a best-fit framework approach with inductive thematic analysis. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Results Fourteen studies involving 150 participants (predominantly men, aged 53–88 years) were included. AAA negatively affected quality of life across the care pathway. Surveillance was characterised by uncertainty and anxiety linked to the asymptomatic and unpredictable nature of the disease. Patients undergoing surgical repair expressed trust in healthcare providers but often lacked sufficient information to participate meaningfully in shared decision-making. Across care stages, individuals sought autonomy, control, and reassurance through ongoing follow-up and accessible information. Misconceptions about lifestyle factors such as exercise and smoking cessation were common, reflecting unmet patient education needs. Conclusion Current evidence highlights the profound psychological burden of AAA and the central role of patient education and patient-centred communication in supporting autonomy and empowerment. Improved information provision, shared decision-making, and attention to lived experiences may enhance quality of life throughout the AAA care pathway.