Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China.
Department of Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
J Adv Nurs. 2021 Jul;77(7):2929-2941. doi: 10.1111/jan.14706. Epub 2021 Jan 22.
To systematically evaluate the effect of intensive care unit diary psychotherapy on the incidence of posttraumatic stress disorder, anxiety, and depression after discharge from intensive care unit.
Many studies have reported the potential advantages and risks of intensive care unit diary psychotherapy in adult patients discharged from intensive care unit, but the results are divergent.
Systematic review and meta-analysis of prospective randomized controlled or case-controlled studies.
Databases such as Cochran Library, Pubmed, Embase, CINAHL, and ProQuest databases, China national knowledge infrastructure (CNKI) were searched for literatures published from January 2000-March 2020.
We use the Cochrane Risk of Bias Tool for quality assessment and audit manager 5.3 software for meta-analysis. The main result is the incidence of posttraumatic stress disorder, anxiety, and depression.
Ten studies meeting the inclusion criteria were identified, including eight randomized controlled studies and two case-controlled studies, with a total of 1,210 patients. The pooled results of this meta-analysis indicated that the intensive care unit diary could reduce the incidence of posttraumatic stress disorder, anxiety, and depression.
This study showed that an intensive care unit diary could improve the psychological symptoms of adult intensive care unit patients after discharge. However, due to limitations such as publication bias and case sample size, the results should be carefully considered. Researchers need to further clarify the multidisciplinary collaborative process of intensive care unit diary therapy, the real beneficiaries, and its impact on family members' psychological status by conducting large, robust studies in the future.
This study's findings suggest that medical staff need to re-examine the role of intensive care unit diary therapy, its standardized implementation and provide effective intervention for reducing psychological stress-related symptoms of intensive care unit patients after discharge.
系统评价 ICU 日记心理疗法对 ICU 出院后创伤后应激障碍、焦虑和抑郁发生率的影响。
许多研究报告了 ICU 日记心理疗法对 ICU 出院患者的潜在益处和风险，但结果存在差异。
对前瞻性随机对照或病例对照研究进行系统评价和荟萃分析。
Cochrane 图书馆、PubMed、Embase、CINAHL 和 ProQuest 数据库以及中国知网等数据库检索 2000 年 1 月至 2020 年 3 月发表的文献。
采用 Cochrane 偏倚风险工具进行质量评估，采用 Audit Manager 5.3 软件进行荟萃分析。主要结果为创伤后应激障碍、焦虑和抑郁的发生率。
共纳入 10 项符合纳入标准的研究，包括 8 项随机对照研究和 2 项病例对照研究，共 1210 例患者。荟萃分析结果表明，ICU 日记可以降低创伤后应激障碍、焦虑和抑郁的发生率。
本研究表明，ICU 日记可以改善成人 ICU 患者出院后的心理症状。但是，由于存在发表偏倚和病例样本量等限制，结果应谨慎考虑。未来的研究需要进一步阐明 ICU 日记治疗的多学科协作过程、真正的受益人群及其对家属心理状态的影响，开展更大规模、更稳健的研究。
本研究结果提示医护人员需要重新审视 ICU 日记心理疗法的作用，规范实施，并为减轻 ICU 患者出院后心理应激相关症状提供有效的干预措施。
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