Analysis of influencing factors of psychological resilience in patients with traumatic fractures and its effect on posttraumatic growth

Abstract

BACKGROUND

Traumatic fractures are mainly caused by various exogenous traumatic events, which not only damage patients’ physical health but also affect their psychological state and aggravate stress responses.

AIM

To analyze the influencing factors of psychological resilience of patients with traumatic fractures and the effect of psychological resilience on posttraumatic growth (PTG).

METHODS

This study included 188 patients with traumatic fractures admitted to the First People’s Hospital of Shangqiu from November 2022 to November 2023. The participants were categorized based on the patient’s psychological resilience assessed by the Connor-Davidson Resilience Scale (CD-RISC) into the better resilience group (CD-RISC score ≥ 60 points, n = 80) and the poor resilience group (CD-RISC score < 60 points, n = 108). Patients’ sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). The identification of the influencing factors of psychological resilience in patients with traumatic fractures was realized by binary Logistic regression (with factors such as sex, age, injury cause, trauma severity, fracture site, personality, and PSQI included for analysis). The determination of the PTG status of all participants used the Chinese version of the Posttraumatic Growth Inventory (C-PTGI). Furthermore, a Spearman correlation analysis was conducted to analyze the association between psychological resilience and PTG.

RESULTS

The psychological resilience of patients with traumatic fractures was related to age, sex, trauma severity, and personality. The better resilience group demonstrated statistically lower PSQI scores than the poor resilience group (P < 0.05). The Logistic regression analysis revealed sex, age, trauma severity, personality, and sleep quality as influencing factors of CD-RISC scores in patients with traumatic fractures (all P < 0.05). The score of each C-PTGI dimension and the total score (relating to others, new possibilities, personal strength, spiritual change, and appreciation of life) were higher in the better resilience group than in the poor resilience group (all P < 0.05). Spearman correlation analysis indicated a positive association of the CD-RISC score in patients with traumatic fractures with the scores of all dimensions of C-PTGI and the total C-PTGI score (all P < 0.05).

CONCLUSION

The factors influencing the psychological resilience of patients with traumatic fractures include age, sex, trauma severity, personality, and sleep quality, and psychological resilience is closely associated with PTG.

Keywords: Traumatic fracture; Psychological resilience; Sleep quality; Posttraumatic growth; Connor-Davidson Resilience Scale; Chinese version of the Posttraumatic Growth Inventory

Core Tip: Traumatic fractures cause different degrees of physical damage to patients. The injured limbs may present with pain, swelling, and ecchymosis. Visceral damage, shock, or even fatality may ensue in severe circumstances, imposing substantial distress and setbacks on patients’ physiological and psychological adaptability. This study included 188 patients with traumatic fractures. The influencing factors of psychological resilience in such patients were confirmed to involve sex, age, trauma severity, personality, and sleep quality. Among female patients, those aged < 40 years, individuals with a higher degree of trauma severity, introverted patients, and those with suboptimal sleep quality, enhanced care, and psychological intervention should be strengthened to improve their psychological resilience as much as possible. This, in turn, exerts a favorable effect on the patient’s posttraumatic growth status. Our study provides effective guidance for the rehabilitation of patients with traumatic fractures.