The mediating effect of rumination thinking between intensive care unit memory and post-traumatic stress disorder in elderly patients with sepsis

Zhang Ning; Ding Jinling; Hao Yuli; Zhao Jingxue; Li Yanan

doi:10.3760/j.issn.1673-4777.2024.11.017

Abstract：Objective To explore the relationship between intensive care unit memory and post-traumatic stress disorder(PTSD)in elderly patients with sepsis transferred from intensive care unit(ICU),and to explore the mediating effect of rumination thinking between ICU memory and PTSD.Methods From January 2020 to December 2023,240 elderly patients with sepsis transferred from ICU in the 305th Hospital of the Chinese People's Liberation Army and the Eighth Medical Center,Chinese PLA General Hospital were selected as the research objects.The general status questionnaire,post-traumatic stress disorder symptom checklist-Chinese version(PCLC),the intensive care unit memory assessment tool(ICUMT)and multidimensional rumination response scale(MRIS)were used to conduct a cross-sectional survey.The effects of patients'general data on rumination thinking,ICU memory and PTSD scores were analyzed.Pearson method was used to analyze the correlation of the three scores,and structural equation model was used to analyze the mediating effect of rumination thinking between ICU memory and PTSD of patients.Results The scores of those with sleep disorders,ventilator assisted ventila-tion,analgesics,and sedatives were higher than those of the other group(all P＜0.05).There was a positive correlation between ICUMT score and MRIS score and PCLC score in elderly patients with sepsis(r=0.550,P＜0.001;r=0.650,P＜0.001),and there was also a positive correlation between MRIS score and PCLC score(r=0.781,P＜0.001).ICU memory had a positive effect on PTSD,and the direct effect value was 0.840.The positive effect of rumination thinking on PTSD was also confirmed,and the direct effect value was 0.100.ICU memory also had an indirect effect on PTSD by affecting rumination thinking,and the effect value was 0.329.Conclusion ICU memory in elderly patients with sepsis has a direct effect on PTSD,and also an indirect effect through rumination thinking.