Zhao Changzheng, Zhou Lancai, Gao Haixia, Lu Yongzan, Shi MiaoMiao
Intensive Care Unit, Shandong Public Health Clinical Center, Jinan, Shandong, China.
Surgical Intensive Care Unit, Shandong Public Health Clinical Center, Jinan, Shandong, China.
Front Public Health. 2025 May 7;13:1589223. doi: 10.3389/fpubh.2025.1589223. eCollection 2025.
Continuous renal replacement therapy (CRRT) is the primary treatment for severe sepsis and has been shown to reduce patient mortality. Patients with severe sepsis who receive CRRT frequently experience significant physical and psychological distress, manifesting as shame, social withdrawal, and abnormal cognitive moods. This study aimed to explore the relationship between psychological resilience, cognitive flexibility, and post-traumatic growth (PTG) levels in patients with severe sepsis treated with CRRT.
From January to October 2024, patients with severe sepsis who were treated with CRRT in our hospital were selected by convenience sampling as the research object. The Connor-Davidson Resilience Scale (CDRISC), Cognitive Flexibility Scale, and Post-Traumatic Growth Inventory (PTGI) were used to evaluate patients' psychological resilience, cognitive flexibility, and PTG levels. Statistical methods included the independent sample t test, Pearson analysis, and linear regression analysis.
The total scores of CDRISC, cognitive flexibility scale and PTGI in 205 patients was (42.98 ± 6.13), (95.04 ± 17.98) and (49.77 ± 9.92), respectively. There was a significant positive correlation between psychological resilience, cognitive flexibility, and PTG levels in patients with severe sepsis treated with CRRT ( < 0.05). Psychological resilience and cognitive flexibility had positive predictive effects on PTG, and there were significant positive predictive effects between psychological resilience and cognitive flexibility ( < 0.05). Psychological resilience directly and positively predicted PTG ( = 0.538, < 0.05). The indirect effect of psychological resilience on cognitive flexibility was significant ( = 0.677, < 0.05), and the indirect effect of cognitive flexibility on PTG was significant ( = 0.165, < 0.05). The chain-mediating effect between psychological resilience, cognitive flexibility, and PTG was significant ( = 0.112, < 0.05).
Psychological resilience can affect the PTG level of patients with severe sepsis treated with CRRT and can also indirectly affect PTG levels through direct chain mediation of cognitive flexibility. Targeted intervention strategies should be formulated to improve mental health and promote clinical prognosis.
连续性肾脏替代治疗(CRRT)是严重脓毒症的主要治疗方法,已被证明可降低患者死亡率。接受CRRT治疗的严重脓毒症患者经常经历显著的身心痛苦,表现为羞耻、社交退缩和认知情绪异常。本研究旨在探讨接受CRRT治疗的严重脓毒症患者心理韧性、认知灵活性与创伤后成长(PTG)水平之间的关系。
采用便利抽样法,选取2024年1月至10月在我院接受CRRT治疗的严重脓毒症患者作为研究对象。采用Connor-Davidson心理韧性量表(CDRISC)、认知灵活性量表和创伤后成长量表(PTGI)评估患者的心理韧性、认知灵活性和PTG水平。统计方法包括独立样本t检验、Pearson分析和线性回归分析。
205例患者的CDRISC、认知灵活性量表和PTGI总分分别为(42.98±6.13)、(95.04±17.98)和(49.77±9.92)。接受CRRT治疗的严重脓毒症患者的心理韧性、认知灵活性和PTG水平之间存在显著正相关(<0.05)。心理韧性和认知灵活性对PTG有正向预测作用,心理韧性和认知灵活性之间也存在显著正向预测作用(<0.05)。心理韧性直接正向预测PTG(=0.538,<0.05)。心理韧性对认知灵活性的间接效应显著(=0.677,<0.05),认知灵活性对PTG的间接效应显著(=0.165,<0.05)。心理韧性、认知灵活性和PTG之间的链式中介效应显著(=0.112,<0.05)。
心理韧性可影响接受CRRT治疗的严重脓毒症患者的PTG水平,也可通过认知灵活性的直接链式中介间接影响PTG水平。应制定有针对性的干预策略,以改善心理健康,促进临床预后。