The association between posttraumatic stress symptoms and hope following intensive care unit discharge: Findings from a longitudinal cohort study

Klara Friberg; Kristin Hofsø; Tone Rustøen; Johan Ræder; Milada Hagen; Kathleen Puntillo; Brita Fosser Olsen

doi:10.1016/j.hrtlng.2024.12.003

The association between posttraumatic stress symptoms and hope following intensive care unit discharge: Findings from a longitudinal cohort study

Heart Lung. 2024 Dec 30:70:223-229. doi: 10.1016/j.hrtlng.2024.12.003. Online ahead of print.

Authors

Klara Friberg¹, Kristin Hofsø², Tone Rustøen³, Johan Ræder⁴, Milada Hagen⁵, Kathleen Puntillo⁶, Brita Fosser Olsen⁷

Affiliations

¹ Østfold Hospital Trust, Intensive Care Department, Postbox 300, 1714 Grålum, Norway; University of Oslo, Institute of Health and Society, Department of Nursing Science, Faculty of Medicine, Postbox 0316 Oslo, Norway. Electronic address: klara.sofia.friberg@so-hf.no.
² Lovisenberg Diaconal University Collage, Oslo, Norway; Oslo University Hospital, Department of Research and Development, Division of Emergencies and Critical Care, Postbox 4950 Nydalen, 0424 Oslo, Norway; Oslo University Hospital, Department of Postoperative and Critical Care Nursing, Division of Emergencies and Critical Care, Postbox 4950 Nydalen, 0424 Oslo, Norway.
³ University of Oslo, Institute of Health and Society, Department of Nursing Science, Faculty of Medicine, Postbox 0316 Oslo, Norway; Lovisenberg Diaconal University Collage, Oslo, Norway.
⁴ University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Postbox 0316 Oslo, Norway.
⁵ Oslo University Hospital, Department of Research and Development, Division of Emergencies and Critical Care, Postbox 4950 Nydalen, 0424 Oslo, Norway; Oslo Metropolitan University, Department of Public Health, Faculty of Health Sciences, Postbox 4, St Olavs plass, 0130 Oslo, Norway.
⁶ University of California, Department of Physiological Nursing, School of Nursing, 2 Koret Way, San Francisco, 94143 California, USA.
⁷ Østfold Hospital Trust, Intensive Care Department, Postbox 300, 1714 Grålum, Norway; Østfold University College, Faculty of Health and Welfare, Postbox 700, 1757 Halden, Norway.

PMID: 39740556
DOI: 10.1016/j.hrtlng.2024.12.003

Abstract

Background: Hope is essential for mental health in general and for recovery following severe illness. However, the associations between posttraumatic stress symptoms (PTSS) and hope among intensive care unit (ICU) survivors has not been investigated.

Objectives: To assess hope at 3, 6 and 12 months after ICU admission and examine possible associations between hope and selected demographic data, clinical characteristics, and 3-month PTSS-levels among ICU patients.

Methods: ICU-patients from Norway self-reported on hope using Herth Hope Index. Data on demographics and clinical characteristics were collected from patient reports and medical records. PTSS were analysed 3 months after admission, using descriptive statistics and linear mixed model regression analyses.

Results: A total of 73 adult ICU survivors were included (male n = 45 (61.6%); median age 66 years [IQR: 51.0;74.0]). Median hope scores were 41, 40, and 42 at 3, 6 and 12 months, respectively. A clinically minor but statistically significant reduction in hope was registered at 6 months (B = -1.24; 95% confidence interval [CI]: -2.25, -0.23; p = 0.016). Lower levels of PTSS 3 months after admission (B = -0.13; 95% CI [-0.23, -0.03]; p = 0.015) and being employed before admission (B = 5.87; 95% CI [1.85, 9.88]; p = 0.004) were significantly associated with higher hope during the first year after admission. A small but statistically significant association was also found between higher hope and a more extended hospital stay (B = 0.08; 95% CI [0.00, 0.15]; p = 0.042).

Conclusions: Hope scores remained stable during the first year after ICU admission. Lower levels of PTSS at 3 months after admission, being employed prior to admission, and having longer hospital stay were associated with higher hope during the first year after admission. Given the small sample, more research in larger samples is needed to enhance the clinical relevance of these findings.

Keywords: Hope; Intensive care unit; Longitudinal; Mixed model for repeated measures; Posttraumatic stress symptoms.