目的 探讨ICU转出患者依恋类型与创伤后成长（posttraumatic growth,PTG）的关系，以及反刍性沉思在两者间的中介作用。 方法 2021年9月至2022年9月，便利抽取上海某三级甲等医院从ICU转出的患者253例为研究对象，采用亲密关系经历简表、反刍性沉思问卷和创伤后成长评定量表进行横断面调查。 结果 ICU转出患者创伤后成长、依恋类型、反刍性沉思得分分别为（66.28±8.42）分、（36.97±9.81）分、（25.89±6.45）分；创伤后成长与依恋回避、依恋焦虑、侵入性反刍呈负相关（均P＜0.05 ），与目的性反刍呈正相关（P＜0.01）；反刍性沉思在依恋类型与PTG间存在一定中介效应。 结论 ICU转出患者的依恋类型对创伤后成长有直接影响，也可以通过反刍性沉思间接影响。临床护士可以根据不同依恋类型患者的认知加工过程，实施个性化心理干预，促进患者的创伤后成长，降低心理问题的发生率。

Objective To explore the relationship between attachment style and posttraumatic growth (PTG) among ICU survivors,and the mediating effect of rumination between them. Methods Convenient sampling was used to select 253 ICU survivors from a tertiary hospital in Shanghai City from September,2021 to September,2022.The experiences in close relationship scale-short form,rumination inventory,and posttraumatic growth inventory were used for cross-sectional survey. Results The scores of posttraumatic growth,attachment style and rumination among ICU survivors were (66.28±8.42),(36.97±9.81) and (25.89±6.45),respectively.Posttraumatic growth was negatively correlated with attachment avoidance,attachment anxiety and intrusive rumination (all P＜0.05),and positively correlated with deliberate rumination (P＜0.01).Rumination played a mediating role between attachment style and posttraumatic growth. Conclusions The attachment style of ICU survivors can directly affect their posttraumatic growth,or indirectly influence posttraumatic growth through rumination.Clinical nurses can implement individualized psychological intervention according to the cognitive processing of patients with different attachment styles,so as to promote the posttraumatic growth of ICU survivors and reduce the incidence of psychological problems.

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上海市市级医院临床科技创新项目（SHDC22022219）