Study On Posttraumatic Growth In Accidentally Injured Patients And Its Intervention Model

[Objectives]To understand the level of posttraumatic growth (PTG) in accidentally injured patients after Motor vehicle accidents and work-place accidents, their posttraumatic growth experiences and process. To identify factors and strategies that influence PTG of the patients and to develop an appropriate intervention model to facilitate PTG of the accidentally injured patients.[Methods]1. Literatures analysis was conducted to describe the research progress and hot spots of PTG, and summarize the influencing factors of PTG. Theoretical analysis was used to explore the appropriate process of posttraumatic growth and the theoretical foundation of this study.2. By using mixed methods design, a cross-sectional study was conducted. The quantitative study was conducted in 180 accidentally injured patients. The instruments include the revised posttraumatic growth inventory(PTGI), the big five inventory(BFI),the impact of event scale-revised(IES-R), and the trait coping style questionnaire(TCSQ) to measure PTG, personality trait, emotional distress and coping style, respectively. Pearson correlations were used to examine the relationships between PTG and demographic and injured characteristics, personality characteristics, emotional distress and coping style. A hierarchical multiple regression analysis was performed to examine the contribution of correlated variables to the report of growth. The qualitative study by using semi-structured in-depth interview was conducted in 10 accidentally injured patients. Transcripts were analyzed using interpretative phenomenological analysis to explore the experiences, process and main influencing factors of patients'posttraumatic growth.3. An initial intervention model to facilitate PTG of accidentally injured patients was developed based on theoretical analysis, quantitative study and qualitative study.[Results]1. By literature review and theoretical analysis, an initial conceptual framework to guide the whole research was developed.2. Quantitative study results:â‘ A ccidentally injured patients in this study reported higher prevalence of PTG compared with other reports. Top three of the most frequently reported growth experience were'I can better appreciate each day (91.11%)','I have more compassion for others (88.89%)', and'I learned a great deal about how wonderful people are (87.22%)'.â‘¡M arital status, age, educational level, type of traumatic event, injury severity, and subjective distress of demographic and injured characteristics were positively correlated with PTGI and its subscales. Extraversion, agreeableness, conscientiousness, openness of the BFI , negative coping and positive coping of TCSQ, and inversion, avoidance and hyperarousal of IES-R were all positively correlated with PTGI and its subscales.â‘¢All the variables entering the model could explain 24.1% of the variance of posttraumatic growth. Variables of demographical and injured characteristics accounted for 9.1% of the variance of posttraumatic growth. Additionally variables of personality trait explained an additional 7.8% of the variance of growth while variables of emotional distress and coping style explained an additional 7.2% of the variance of growth.3. Qualitative study results:â‘ PTG experiences in accidentally injured patients can be included into four themes which were positive construction of meaning, perception of self, perception of connection and perception of life philosophy.â‘¡Trajectory of PTG occurred can be generalized to three stages which were devastation, acceptation, rebuilding and integration. The psychological experiences of injured patients could be described as'deeply distress, growth effort, and approaching growth.'â‘¢T he main influencing factors of PTG included personal resources, cognitive progress about traumatic information, coping and environmental resources.4. Based on qualitative results, comparing quantitative results, a stage model of PTG in accidentally injured patients were developed.5. An initial intervention model to facilitate PTG of accidentally injured patients was developed.â‘ The model highlighted the growth as the injured patients approached it. Personal resources (such as personality trait and pre-trauma experiences), cognitive processing about traumatic information, coping strategies and environmental resources were the main factors influencing PTG in accidentally injured patients.â‘¡In terms of intervention goals, clinicians should focus on'perception of self, perception of relationship with others and perception of life philosophy'to foster PTG in injured patients,â‘¢According to the psychological process of the injured patients including'devastation, acceptation, rebuild and integration', nurses should follow the interventional principles of perception and judgments, engagement and share, challenge and study', respectively.â‘£In terms of strategies, nurses should focus on increasing the perception of personal resources, promoting the cognitive processing and effective coping, and establishing an atmosphere perception and safety of social support.[Conclusion]1. Accidentally injured patients in this study reported high level of posttraumatic growth. Their posttraumatic growth includes three dimensions which were perception of self, perception of relationship with others and perception of life philosophy. But how to understand the meaning of PTG should based on particular background and culture.2. The stage model of posttraumatic growth developed in this study could be the evidence for clinical works to understand the posttraumatic growth in accidentally injured patients.3. The intervention model in this study, including intervention goals, intervention principles, and the key points and strategies of facilitating PTG of accidentally injured patients, is scientific and practicable for clinical work.It could instruct nurses how to integrate the new perspective of PTG into clinical psychological practice.4. There're some critical aspects and concerns about the clinical utility of this developed intervention model. First, the concept of PTG adds a new perspective, not a new treatment, into psychotherapy. Second, notice growth as the injured patients approaches it. Third, believe that PTG is possible for all injured patients but remember that the presence of growth should not be regard as goals of psychological well beings.5. Further interventional study should be done to examine the effective of the intervention model, to determine the contribution of posttraumatic growth to long-term quality of life in accidentally injured patients.