Preventive Narrative Exposure Intervention for PTSD in ICU Patients After Cardiopulmonary Bypass Cardiac Surgery (ICU-pNET)
Effects of Preventive Narrative Exposure Intervention on Posttraumatic Stress Disorder Among ICU Patients After Cardiopulmonary Bypass Cardiac Surgery: A Randomized Controlled Trial
This clinical trial aims to evaluate whether an ICU-based preventive narrative exposure intervention can help prevent posttraumatic stress symptoms in adult patients after cardiac surgery with cardiopulmonary bypass.
The study will include adult patients who undergo cardiac surgery with cardiopulmonary bypass and are admitted to the cardiac surgical intensive care unit. Participants will be randomly assigned to either the intervention group or the control group.
Participants in the control group will receive routine care and routine psychological support. Participants in the intervention group will receive routine care plus an ICU-based preventive narrative exposure intervention supported by an ICU visitor book. The intervention includes preoperative education, review of ICU experiences, construction of a timeline, guided narration of stressful ICU-related events, and integration of the experience before discharge.
The ICU visitor book includes selected photos, family messages, and key recovery events. It is used to help patients better understand and organize their ICU experience.
Researchers will compare the intervention group with the control group to see whether the intervention reduces posttraumatic stress symptoms. The primary outcome is posttraumatic stress symptoms at 1 month after discharge. Secondary outcomes include posttraumatic stress symptoms at 3 months after discharge, ICU memories, anxiety, depression, sleep quality, quality of life, and patient and family satisfaction with ICU care.
The findings may provide evidence for an early psychological nursing intervention to prevent posttraumatic stress disorder in ICU patients after cardiopulmonary bypass cardiac surgery.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Patients admitted to the intensive care unit after cardiac surgery with cardiopulmonary bypass may experience stressful events such as mechanical ventilation, invasive procedures, physical restriction, noise from monitoring devices, sleep disturbance, and uncertainty about their condition. These experiences may lead to fragmented ICU memories, gaps in factual understanding, frightening or unreal memories, and a persistent sense of threat after discharge. These factors may increase the risk of posttraumatic stress symptoms.
Existing supportive approaches, such as routine psychological education or ICU diaries, may help patients obtain factual information and emotional support. However, they may not sufficiently support patients in actively organizing and processing stressful ICU-related memories. Therefore, this study will test an ICU-based preventive narrative exposure intervention designed for patients after cardiopulmonary bypass cardiac surgery.
The intervention is delivered during the perioperative and early recovery period. It uses an ICU visitor book as a narrative support tool. The visitor book contains selected and privacy-protected photos, family messages, and key recovery events. These materials are used to help patients reconstruct the timeline of their ICU experience, understand what happened during treatment, and narrate stressful events in a guided and structured way. The intervention also includes brief education about stress reactions, grounding strategies, review of ICU experiences, and integration of the experience before discharge.
The intervention is preventive rather than therapeutic treatment for diagnosed posttraumatic stress disorder. It is intended to help patients form a more coherent and understandable account of their ICU experience, reduce distress related to fragmented or frightening memories, and support psychological recovery after cardiac surgery.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Rongjin Lin
- Número de telefone: +86-18276524344
- E-mail: Yaling_Qin0202@163.com
Locais de estudo
-
-
Fujian
-
Fuzhou, Fujian, China, 35005
- Recrutamento
- The First Affiliated Hospital of Fujian Medical University
-
Contato:
- Rongjin Lin
- Número de telefone: +86-18276524344
- E-mail: Yaling_Qin0202@163.com
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Aged 18 years or older.
- Scheduled to undergo cardiac surgery with cardiopulmonary bypass, with planned postoperative admission to the cardiac surgical intensive care unit and an expected ICU stay of more than 24 hours.
- The participant is able to communicate effectively, and the participant and family members are willing to cooperate with the study.
- Conscious before the first postoperative intervention, negative for delirium as assessed by the Confusion Assessment Method for the Intensive Care Unit, and able to understand and complete the intervention and related assessments.
Exclusion Criteria:
- Experienced severe traumatic events within the past year, such as diagnosis of a major disease unrelated to the current cardiac condition in the participant or an immediate family member, or death of an immediate family member or significant other.
- Currently receiving treatment for mental disorders, including pharmacological treatment or psychotherapy for conditions such as depressive disorder, anxiety disorder, bipolar disorder, or schizophrenia spectrum disorders.
- History of a clearly diagnosed severe mental disorder, or mental abnormalities caused by organic brain disease.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Prevenção
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: ICU-pNET Group
Participants in this group will receive routine care plus an ICU-based preventive narrative exposure intervention supported by an ICU visitor book.
|
The intervention is an ICU-based preventive narrative exposure intervention supported by an ICU visitor book.
It includes preoperative education, review of ICU experiences, construction of a timeline, guided narration of stressful ICU-related events, and integration of the experience before discharge.
The ICU visitor book includes selected photos, family messages, and key recovery events to help participants better understand and organize their ICU experience.
|
|
Sem intervenção: Control Group
Participants in this group will receive routine care and routine psychological support during the perioperative and ICU recovery period.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Posttraumatic Stress Symptoms
Prazo: 1 month after hospital discharge
|
Posttraumatic stress symptoms will be assessed using the Impact of Event Scale-Revised.
The total score ranges from 0 to 88, with higher scores indicating more severe posttraumatic stress symptoms.
|
1 month after hospital discharge
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Posttraumatic stress symptoms at 3 months after hospital discharge
Prazo: 3 months after hospital discharge
|
Posttraumatic stress symptoms will be assessed using the Impact of Event Scale-Revised.
The total score ranges from 0 to 88, with higher scores indicating more severe posttraumatic stress symptoms.
|
3 months after hospital discharge
|
|
ICU-related memories
Prazo: Within 48 hours after ICU discharge, 1 month and 3 months after hospital discharge.
|
ICU-related memories will be assessed using the ICU Memory Tool, a questionnaire designed to assess patients' recall of their ICU stay, including factual memories, memories of feelings, and delusional memories.
|
Within 48 hours after ICU discharge, 1 month and 3 months after hospital discharge.
|
|
Anxiety and depression symptoms
Prazo: Baseline, within 48 hours after ICU discharge, before hospital discharge, 1 month and 3 months after hospital discharge.
|
Anxiety and depression symptoms will be assessed using the Hospital Anxiety and Depression Scale (HADS).
The HADS includes 14 items and consists of two subscales for anxiety and depression, with each subscale ranging from 0 to 21.
Higher scores indicate more severe anxiety or depression symptoms.
|
Baseline, within 48 hours after ICU discharge, before hospital discharge, 1 month and 3 months after hospital discharge.
|
|
Sleep quality
Prazo: Baseline, within 48 hours after ICU discharge, before hospital discharge, 1 month and 3 months after hospital discharge.
|
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index.
The scale includes seven components, with the total score ranging from 0 to 21.
Higher scores indicate poorer sleep quality.
|
Baseline, within 48 hours after ICU discharge, before hospital discharge, 1 month and 3 months after hospital discharge.
|
|
Health-related quality of life
Prazo: 1 month and 3 months after hospital discharge
|
Health-related quality of life will be assessed using the 36-Item Short Form Health Survey.
The scale includes 36 items covering eight domains of health status.
Scores are transformed to a 0 to 100 scale, with higher scores indicating better health-related quality of life.
|
1 month and 3 months after hospital discharge
|
|
Patient satisfaction with ICU nursing care
Prazo: 1 week after ICU discharge
|
Patient satisfaction with ICU nursing care will be assessed using the ICU Patient Hospitalization Satisfaction Questionnaire.
The questionnaire includes 10 items rated on a 5-point Likert scale.
Higher total scores indicate higher patient satisfaction.
|
1 week after ICU discharge
|
|
Family satisfaction with ICU care
Prazo: 1 week after ICU discharge
|
Family satisfaction with ICU care will be assessed using the Chinese version of the Critical Care Family Satisfaction Survey.
The scale includes 27 items rated on a 5-point Likert scale, with total scores ranging from 27 to 135.
Higher scores indicate higher family satisfaction.
|
1 week after ICU discharge
|
Colaboradores e Investigadores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 2025-026-02
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .