Critical-illness survivors may experience post-traumatic stress disorder (PTSD) and quality-of-life impairments. Resilience may protect against psychological trauma but has not been adequately studied after critical illness. We assessed resilience and its associations with PTSD and quality of life, and also identified factors associated with greater resilience. This prospective, multicentre, study in patients recruited at 41 French ICUs was done in parallel with the NUTRIREA-3 trial in patients given mechanical ventilation and vasoactive amines for shock. Three months to one year after intensive-care-unit admission, survivors completed the Connor-Davidson Resilience Scale (CD-RISC-25), Impact of Event-Revised scale for PTSD symptoms (IES-R), SF-36 quality-of-life scale, Multidimensional Scale of Perceived Social Support (MSPSS), and Brief Illness Perception Questionnaire (B-IPQ). Of the 382 included patients, 203 (53.1%) had normal or high resilience (CD-RISC-25 ≥ 68). Of these resilient patients, 26 (12.8%) had moderate to severe PTSD symptoms (IES-R ≥ 24) vs. 45 (25.4%) patients with low resilience (p = 0.002). Resilient patients had higher SF-36 scores. Factors independently associated with higher CD-RISC-25 scores were higher MSPSS score indicating stronger social support (OR, 1.027; 95%CI 1.008–1.047; p = 0.005) and lower B-IPQ scores indicating a more threatening perception of the illness (OR, 0.973; 95%CI 0.950–0.996; p = 0.02). Resilient patients had a lower prevalence of PTSD symptoms and higher quality of life scores, compared to patients with low resilience. Higher scores for social support and illness perception were independently associated with greater resilience. Thus, our findings suggest that interventions to strengthen social support and improve illness perception may help to improve resilience. Such interventions should be evaluated in trials with PTSD mitigation and quality-of-life improvement as the target outcomes.

中文翻译：

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严重危重疾病后的恢复能力：一项前瞻性、多中心、观察性研究 (RESIREA)


危重疾病幸存者可能会出现创伤后应激障碍（PTSD）和生活质量受损。复原力可以防止心理创伤，但在危重疾病后尚未得到充分研究。我们评估了复原力及其与创伤后应激障碍和生活质量的关联，并确定了与更强的复原力相关的因素。这项前瞻性多中心研究是在 41 个法国 ICU 招募的患者中进行的，与 NUTRIREA-3 试验同时进行，研究对象是接受机械通气和血管活性胺治疗休克的患者。入住重症监护病房后三个月至一年，幸存者完成了康纳-戴维森复原力量表 (CD-RISC-25)、PTSD 症状事件影响修订量表 (IES-R)、SF-36 质量评估-生活量表、感知社会支持多维量表（MSPSS）和简短疾病感知问卷（B-IPQ）。在 382 名纳入的患者中，203 名 (53.1%) 具有正常或高弹性 (CD-RISC-25 ≥ 68)。在这些有弹性的患者中，26 名 (12.8%) 患有中度至重度 PTSD 症状 (IES-R ≥ 24)，而 45 名 (25.4%) 患者有低弹性 (p = 0.002)。有弹性的患者有较高的 SF-36 分数。与较高的 CD-RISC-25 分数独立相关的因素是较高的 MSPSS 分数，表明更强的社会支持（OR，1.027；95%CI 1.008–1.047；p = 0.005）和较低的 B-IPQ 分数，表明对疾病的威胁更大（或，0.973；95%CI 0.950–0.996；p = 0.02）。与低复原力患者相比，复原力强的患者 PTSD 症状发生率较低，生活质量得分较高。较高的社会支持和疾病认知得分与较高的复原力独立相关。 因此，我们的研究结果表明，加强社会支持和改善疾病认知的干预措施可能有助于提高复原力。此类干预措施应在以缓解 PTSD 和改善生活质量为目标结果的试验中进行评估。