Trajectory and Determinants of Post-Traumatic Growth in ICU Patients With Mechanical Ventilation: A Prospective,...

Post-traumatic growth (PTG) in critically ill patients, particularly those receiving mechanical ventilation (MV), may follow distinct trajectories. However, the patterns and predictors of PTG trajectories in this population remain unclear.

To explore the potential categories and influencing factors of PTG trajectories in ICU patients receiving mechanical ventilation and to provide evidence for developing personalized psychological interventions for patients with different growth trajectories.

A study with a prospective cohort design was conducted from October 17, 2025 to January 31, 2026. Patients receiving mechanical ventilation in the general ICU and EICU of a tertiary hospital in Tai'an City, China were recruited using convenience sampling. Data were collected using a general information questionnaire, the Post-traumatic Growth Scale, the Social Support Rating Scale, the Distress Disclosure Index, the Event-Related Rumination Inventory (simplified Chinese version) and the Simplified Coping Style Questionnaire. A latent class growth mixed model was applied to identify PTG trajectories, and univariate analysis followed by multivariate logistic regression was used to examine influencing factors.

A total of 287 valid questionnaires were included in the final analysis. Three distinct PTG trajectory classes were identified: a low-level stable group (32.8%), a progressive growth group (37.3%), and a high initial-attenuation group (29.9%). Multivariate logistic regression showed that education level, APACHE II score, duration of mechanical ventilation, positive coping style score, purposeful rumination score, and social support score were significant predictors of PTG trajectory class membership.

Post-traumatic growth in ICU patients receiving mechanical ventilation follows three distinct trajectories characterized by group heterogeneity. Nursing staff should develop targeted psychological interventions based on patients' different PTG trajectories.

Identifying PTG trajectories allows clinicians to recognize patients at risk of persistently low growth or initial decline. Person-centred strategies-such as enhancing positive coping, promoting purposeful rumination and strengthening social support-can be implemented to facilitate psychological recovery in mechanically ventilated ICU patients.