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Multicenter Study Observational Study
Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA).
- Alice Mathieu, Jean Reignier, Amélie Le Gouge, Gaetan Plantefeve, Jean-Paul Mira, Laurent Argaud, Pierre Asfar, Julio Badie, Nicolae-Vlad Botoc, Hoang-Nam Bui, Delphine Chatellier, Louis Chauvelot, Christophe Cracco, Michael Darmon, Agathe Delbove, Jérôme Devaquet, Louis-Marie Dumont, Olivier Gontier, Samuel Groyer, Yannick Hourmant, Samir Jaber, Fabien Lambiotte, Benjamin Madeux, Julien Maizel, Olivier Martinet, Virginie Maxime, Emmanuelle Mercier, Mai-Anh Nay, Saad Nseir, Gael Piton, QuenotJean-PierreJPService de Médecine Intensive Réanimation, Centre Hospitalier Universitaire François Mitterrand, Dijon, France.Lipness Team, INSERM, LabExLipSTIC, Université de Bourgogne, Dijon, France.INSERM Centres d'Investigation Clinique, Départeme, Anne Renault, Jean-Philippe Rigaud, Francis Schneider, Michel Sirodot, Bertrand Souweine, Fabienne Tamion, Didier Thévenin, Nathalie Thieulot-Rolin, Francois Tinturier, Patrice Tirot, Isabelle Vinatier, Christophe Vinsonneau, LascarrouJean-BaptisteJBCHU Nantes, Movement - Interactions - Performance, MIP, UR 4334, Nantes Université, 44000, Nantes, France.Médecine Intensive Réanimation, Nantes Université, CHU Nantes, 44000, Nantes, France., Alexandra Laurent, NUTRIREA-3 Trial Investigators, and Clinical Research In Intensive Care and Sepsis (CRICS-TRIGGERSEP) Group.
- Laboratoire de Psychologie: Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), Université de Bourgogne Franche-Comté, EA7458, Dijon, France.
- Crit Care. 2024 Jul 12; 28 (1): 237237.
BackgroundCritical-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.MethodsThis 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).ResultsOf 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).ConclusionsResilient 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.© 2024. The Author(s).
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