Effect of combined pulmonary-psychological nursing on posttraumatic stress disorder in patients with acute respiratory distress syndrome

doi:10.5498/wjp.v16.i4.114419

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World Journal of Psychiatry

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World J Psychiatry. Apr 19, 2026; 16(4): 114419
Published online Apr 19, 2026. doi: 10.5498/wjp.v16.i4.114419

Effect of combined pulmonary-psychological nursing on posttraumatic stress disorder in patients with acute respiratory distress syndrome

Xin Liu, Jing Zhao, Yue-Xia Wang, Yong-Ju Pei, Xin-Ping Shi, Sheng-Wei Peng

Xin Liu, Jing Zhao, Yong-Ju Pei, Xin-Ping Shi, Sheng-Wei Peng, Department of Respiratory Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China

Yue-Xia Wang, Department of Respiratory and Critical Care Medicine, Ward I, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China

Co-first authors: Xin Liu and Jing Zhao.

Author contributions: Liu X and Zhao J are the co-first authors of this study and have made equal contributions, including study design and manuscript preparation; Liu X, Zhao J, and Peng SW conducted the collation and statistical analysis, and wrote the original manuscript and revised the paper; Wang YX, Pei YJ, and Shi XP designed the experiments and conducted clinical data collection, performed postoperative follow-up and recorded the data. All authors read and approved the final manuscript.

Supported by 2021 Henan Medical Science and Technology Research and Development Plan (Joint Construction) Project, No. LHGJ20210008.

Institutional review board statement: This study was approved by the Institutional Review Board of Henan Provincial People’s Hospital, No. 2022(93).

Informed consent statement: The Ethics Committee of Henan Provincial People’s Hospital agrees to waive informed consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: All data generated or analyzed during this study are included in this published article.

Corresponding author: Sheng-Wei Peng, Department of Respiratory Intensive Care Unit, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou 450003, Henan Province, China. 13525507718@163.com

Received: October 24, 2025
Revised: November 20, 2025
Accepted: January 5, 2026
Published online: April 19, 2026
Processing time: 157 Days and 2.1 Hours

Abstract

BACKGROUND

Survivors of acute respiratory distress syndrome (ARDS) frequently suffer from long-term physical and psychological sequelae, including impaired lung function and posttraumatic stress disorder (PTSD), highlighting the need for comprehensive rehabilitation strategies.

AIM

To evaluate the impact of staged pulmonary rehabilitation nursing combined with cognitive psychological intervention (SPRNCPI) on PTSD in patients with ARDS.

METHODS

A retrospective analysis was conducted on the data of 230 patients with ARDS admitted from April 2020 to April 2024. The patients were divided into two groups: A routine care (RC) group (n = 125) and a SPRNCPI group (n = 105). The SPRNCPI group received mechanical ventilation support, RC, and additional staged pulmonary rehabilitation nursing combines with cognitive psychological interventions including psychological support, emotional management training, and regular follow-ups. Baseline demographic information, respiratory function parameters, oxygenation index, serum cortisol levels, PTSD symptoms, emotional status, and quality of life were assessed.

RESULTS

After nursing, forced expiratory volume in one second (P < 0.001), forced vital capacity (P = 0.009), and PaO₂/FiO₂ (P = 0.005) were significantly higher in the SPRNCPI group than in the RC group. Serum cortisol levels (P = 0.002), Impact of Event Scale-Revised overall score (P < 0.001), Self-Rating Anxiety Scale (P = 0.002), and Self-Rating Depression Scale (P < 0.001) scores were significantly lower in the SPRNCPI group. Physiological field scores (P = 0.033), psychological field scores (P = 0.015), social field scores (P = 0.043), and environmental field scores (P = 0.010) were significantly higher in the SPRNCPI group.

CONCLUSION

SPRNCPI significantly improves respiratory function, reduced PTSD symptoms, lowered anxiety and depression levels, and enhanced overall quality of life in patients with ARDS. This integrated approach offers a promising strategy for enhancing patient outcomes in critical care settings.

Keywords: Acute respiratory distress syndrome; Pulmonary rehabilitation; Cognitive psychological intervention; Posttraumatic stress disorder; Mental health; Nursing

Core Tip: This study demonstrates that a novel, integrated protocol combining staged pulmonary rehabilitation nursing with cognitive psychological intervention offers a holistic approach for survivors of acute respiratory distress syndrome. Unlike routine care, this combined strategy significantly improved not only respiratory function and oxygenation but also mitigated psychological trauma, effectively reducing symptoms of posttraumatic stress disorder, anxiety, and depression. This underscores the critical need to address both physical and mental health in acute respiratory distress syndrome recovery to enhance overall patient outcomes.