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

Abstract

Background: Hope is essential for mental health in general and for recovery following severe illness. However, the associations between post-traumatic 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.