Beyond membership: how active sports club participation shapes happiness.

Aortic dissection (AD) is a disease in which the intima of the aorta tears from part of the media under the impact of local velocity and local pressure blood flow (). The blood flow passes through the tear cavity, dividing the aortic lumen into a true lumen and a false lumen, with one or more tear openings present (). Aortic dissection can lead to organ damage, including renal failure and intestinal injury, stroke, aortic valve injury and pericardial tamponade, which may eventually result in disability and/or death (). The global reported incidence of aortic dissection ranges from 2.5 to 17.6 per 100,000 person-years (). In recent years, with the continuous development of medical technology, the survival rate of AD patients treated by surgery has been increasing year by year (). However, there are still high-risk factors for aortic diseases and related cardiovascular events in patients, which seriously reduce the quality of life of patients and bring a large economic burden to individuals and society (). Studies have shown that effective health-promoting behavioral interventions for patients with cardiovascular disease can improve cardiac function, enhance quality of life, and reduce the risk of disease recurrence (). Health-promoting behavioral refers to a series of activities taken by individuals to achieve optimal health and realize self-worth (). The areas of health promoting behaviors include nutrition, physical activity, stress management, health responsibilities, interpersonal relationships, and spiritual growth (). Health promoting behaviors that have been recommended for patients with AD include dietary control, physical activity, cessation of smoking, medication adherence, and adherence to medical recommendations (including monitoring blood pressure and body weight daily) (). Therefore, an in-depth understanding of the factors affecting health promotion behaviors in patients with aortic constriction is important for developing targeted interventions to improve their health outcomes. A qualitative study using the COM-B model identified key factors influencing health-promoting behaviors: psychological abilities (e.g., lack of disease knowledge, limited physical functions, fatigue), physical opportunities (e.g., limited access to information, doctor-patient communication, objective condition limitations), and motivations (e.g., self-efficacy, perceived benefits, personal and family responsibilities) (). However, there are still deficiencies in the research in this field at present. Firstly, there are relatively few quantitative and longitudinal studies on the health behaviors of AD patients, making it difficult to comprehensively evaluate the long-term effects of health behaviors. Secondly, while most existing health promotion programs are based on the theory of health behavior change, further exploration is still needed regarding specific intervention measures and effect evaluation (). At the same time, it is not clear what the trajectory characteristics and population heterogeneity of health promotion behaviors in patients with aortic dissection are, as well as the factors related to the trajectory of health promotion behaviors.