Nurse-Led Longitudinal Screening and Care Transitions for Post-Traumatic Stress Symptoms After Acute Type A Aortic Dissection: A 12-Month Retrospective Longitudinal Cohort Study
- 1Department of Cardiac Surgery Intensive Care Unit, Henan Provincial Chest Hospital, Zhengzhou, Henan Province, 450000, People’s Republic of China
Abstract
Objective: To identify longitudinal trajectories of post-traumatic stress symptoms (PTSS) after acute type A aortic dissection (ATAAD) and to examine baseline and time-varying psychological factors associated with subsequent symptom burden in a nurse-led follow-up cohort.
Methods: This single-center retrospective longitudinal cohort study included 278 ATAAD survivors discharged from Henan Provincial Chest Hospital between 1 August 2023 and 30 July 2024. Clinical and nurse-led follow-up records through 1 August 2025 were reviewed for assessments at discharge and at 1, 3, 6, and 12 months. The primary trajectory analysis used PCL-5 scores from 1 to 12 months among participants with at least two valid assessments. One- through four-class latent class mixed models were compared according to convergence, Bayesian information criterion, classification quality, and minimum class size. Baseline correlates were examined with multinomial regression. Lagged models separated between-person means from within-person changes in illness threat, insomnia, and repetitive negative thinking; social support was examined across the 3-to-6-month interval.
Results: A three-class solution was selected: low-decreasing (n=153, 55.0%), recovering (n=77, 27.7%), and persistent-high (n=48, 17.3%). Within-person increases in illness threat, insomnia, and repetitive negative thinking were associated with higher subsequent PCL-5 scores, whereas higher social support was associated with a lower subsequent score. Baseline associations were attenuated after multiplicity correction.
Conclusion: The model identified three PTSS trajectories during the first year after ATAAD discharge. Repeated nurse-led assessment may help identify survivors with a persistent symptom burden, and changes in illness threat, insomnia, repetitive negative thinking, and social support may inform the timing and focus of transitional care. The effectiveness of screening or targeted care was not tested.
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BibTeX
@article{tang2026nurseled,
title = {{Nurse-Led Longitudinal Screening and Care Transitions for Post-Traumatic Stress Symptoms After Acute Type A Aortic Dissection: A 12-Month Retrospective Longitudinal Cohort Study}},
author = {Hao Tang and Yongting Wang and Tiantian Jia and Mengdan Ma and Faming He},
journal = {Journal of Multidisciplinary Healthcare},
year = {2026},
month = oct,
doi = {10.2147/jmdh.s648723},
url = {https://doi.org/10.2147/jmdh.s648723},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Nurse-Led Longitudinal Screening and Care Transitions for Post-Traumatic Stress Symptoms After Acute Type A Aortic Dissection: A 12-Month Retrospective Longitudinal Cohort Study
AU - Hao Tang
AU - Yongting Wang
AU - Tiantian Jia
AU - Mengdan Ma
AU - Faming He
PY - 2026
DA - 2026/10/26
JO - Journal of Multidisciplinary Healthcare
DO - 10.2147/jmdh.s648723
UR - https://doi.org/10.2147/jmdh.s648723
AB - Objective: To identify longitudinal trajectories of post-traumatic stress symptoms (PTSS) after acute type A aortic dissection (ATAAD) and to examine baseline and time-varying psychological factors associated with subsequent symptom burden in a nurse-led follow-up cohort. Methods: This single-center retrospective longitudinal cohort study included 278 ATAAD survivors discharged from Henan Provincial Chest Hospital between 1 August 2023 and 30 July 2024. Clinical and nurse-led follow-up records through 1 August 2025 were reviewed for assessments at discharge and at 1, 3, 6, and 12 months. The primary trajectory analysis used PCL-5 scores from 1 to 12 months among participants with at least two valid assessments. One- through four-class latent class mixed models were compared according to convergence, Bayesian information criterion, classification quality, and minimum class size. Baseline correlates were examined with multinomial regression. Lagged models separated between-person means from within-person changes in illness threat, insomnia, and repetitive negative thinking; social support was examined across the 3-to-6-month interval. Results: A three-class solution was selected: low-decreasing (n=153, 55.0%), recovering (n=77, 27.7%), and persistent-high (n=48, 17.3%). Within-person increases in illness threat, insomnia, and repetitive negative thinking were associated with higher subsequent PCL-5 scores, whereas higher social support was associated with a lower subsequent score. Baseline associations were attenuated after multiplicity correction. Conclusion: The model identified three PTSS trajectories during the first year after ATAAD discharge. Repeated nurse-led assessment may help identify survivors with a persistent symptom burden, and changes in illness threat, insomnia, repetitive negative thinking, and social support may inform the timing and focus of transitional care. The effectiveness of screening or targeted care was not tested.
SN - 1178-2390
ER -