Year: 2025
Type: article
Study design: Observational Study
Abstract: Importance: Posttraumatic growth (PTG) refers to positive psychological changes following adversity, including deeper relationships and a greater appreciation for life. Objective: To assess PTG among intensive care unit (ICU) health care professionals 4 years after the COVID-19 pandemic and explore its association with resilience, anxiety, and depression. Design, Setting, and Participants: This cross-sectional study invited ICU health care professionals (nursing staff, medical staff [residents, interns, clinical fellows, and senior intensivists], and other professionals providing patient care) in ICUs in general or university-affiliated hospitals in France and Belgium to complete online questionnaires between March 15 and May 15, 2024. Exposures: PTG, resilience, anxiety, and depression. Main Outcomes and Measures: The primary outcome was PTG, and secondary outcomes were anxiety, depression, and resilience. Participants completed validated self-reported questionnaires, including the Posttraumatic Growth Inventory (PTGI), Hospital Anxiety and Depression Scale (HADS), and 10-item Connor-Davidson Resilience Scale (CD-RISC 10). Visual analog scales (VASs) assessed professional experiences and psychological impact. Multivariate linear regression identified factors associated with PTG. Results: Among 1371 health care professionals in 23 ICUs, 850 (62%) responded (median age, 39 years [IQR, 32-46 years]; 574 [68%] women). The median PTGI score was 50 (IQR, 33-64), with nursing staff reporting higher PTG than medical staff (51 [IQR, 34-65] vs 47 [IQR, 28-61]; P = .02), mainly in personal strength, spiritual change, and appreciation of life. Anxiety and depression symptoms were present in 492 respondents (58%) and 219 respondents (26%), respectively. Lower PTG was associated with psychological fatigue (regression coefficient, 1.43; 95% CI, 0.91-1.96; P < .001), ICU conflicts (regression coefficient, 0.62; 95% CI, 0.05-1.19; P = .03), and perceived deterioration in family-centered care (regression coefficient, -7.47; 95% CI, -1.10 to -13.80; P = .02). Higher PTG was correlated with higher resilience (Spearman correlation coefficient, 0.24; 95% CI, 0.17-0.30; P < .001) and was associated with a change in personal life since the pandemic (regression coefficient, 1.80 [95% CI, 1.13-2.47] per VAS point; P < .001). Conclusions and Relevance: In this cross-sectional study performed 4 years after the start of the COVID-19 pandemic, ICU health care professionals, particularly nursing staff, exhibited significant PTG. Resilience, rather than psychological distress, emerged as a key driver of PTG, and deterioration in family-centered care was a major contributing factor, underscoring the need for targeted well-being and resilience-building strategies to enhance health care professionals' mental health and professional fulfillment while also improving patient and family care.
Source: JAMA Network Open
Authors: Élie Azoulay, Laurent Argaud, Vincent Labbé, Guillaume Dumas, Fabrice Bruneel, Mercé Jourdain, Christophe Guitton, Amélie Seguin, Samir Jaber, David Schnell, Isabelle Vinatier, Fanny Ardisson, Michel Ramakers, Antoine Herault, Olivier Lesieur, Alain Cariou, Antoine Vieillard-Baron, Olivier Guisset, Frédéric Pochard, Michael Darmon, Nancy Kentish-Barnes
Institutions: Inserm, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Louis, Institut de recherche Saint-Louis, Hospices Civils de Lyon, Hôpital Edouard Herriot, Université Libre de Bruxelles, Centre Hospitalier Universitaire de Grenoble, Université Grenoble Alpes, Hôpital André Mignot, Centre Hospitalier de Versailles, Hôpital Roger Salengro, Centre Hospitalier du Mans, Centre Hospitalier Universitaire de Nantes, Laboratoire Motricité, Interactions, Performance, Nantes Université, Centre Hospitalier Universitaire de Montpellier, Hôpital Saint Eloi, Centre Hospitalier d'Angoulême, Centre Hospitalier Départemental Vendée, Centre Hospitalier Universitaire Pointe-à-Pitre, Centre Hospitalier Universitaire de Rouen, Centre Hospitalier de La Rochelle, Université Paris Cité, Hôpital Cochin, Université de Versailles Saint-Quentin-en-Yvelines, Centre de recherche en Epidémiologie et Santé des Populations, Hôpital Ambroise-Paré, Hôpital Saint-André
Language: English
Topic: COVID-19 and Mental Health
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W4413508712