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

Figure 1

Flowchart of patient recruitment and exclusion.

Figure 2

Analysis of sleep quality in the better and poor resilience groups. ^cP < 0.001. PSQI: Pittsburgh Sleep Quality Index.

Figure 3

Analysis of the posttraumatic growth of the better and poor resilience groups. A: Inter-group comparison of scores in terms of relating to others; B: Inter-group comparison of scores in terms of new possibilities; C: Inter-group comparison of scores in terms of personal strength; D: Inter-group comparison of scores in terms of spiritual change; E: Inter-group comparison of scores in terms of appreciation of life; F: Inter-group comparison of scores in terms of the total score. ^aP < 0.05, ^bP < 0.01.

Figure 4

Relationship between psychological resilience and posttraumatic growth. A: Correlation between resilience and Chinese version of the Posttraumatic Growth Inventory (C-PTGI) (relating to others); B: Correlation between resilience and C-PTGI (new possibilities); C: Correlation between resilience and C-PTGI (personal strength); D: Correlation between psychological resilience and C-PTGI (spiritual change); E: The correlation between resilience and C-PTGI (appreciation of life); F: Correlation between resilience and C-PTGI (total score). C-PTGI: Chinese version of the Posttraumatic Growth Inventory.