Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland.
Department of Clinical Nursing, Medical University of Warsaw, Warsaw, Poland.
Int J Nurs Stud. 2022 Jan;125:104100. doi: 10.1016/j.ijnurstu.2021.104100. Epub 2021 Oct 2.
The COVID-19 pandemic has exacerbated the consequences of a patient's admission to critical care settings, causing families to face more psychosocial issues than in previous years. Thus, nurses and other clinicians need to keep abreast of interventions that support the families of critical care patients.
To provide evidence of nurse-led family interventions and their family outcomes in adult critical care settings.
A mixed method systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist.
The search included both a screen of relevant databases (PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Library) and the screening of citations in relevant articles. Studies published in the English language between January 2010 and October 2020 were considered. The final database searches were performed on 20 October 2020.
Screening and eligibility assessment were conducted using the Rayyan software. Studies describing the family outcomes of nurse-led interventions in adult critical care settings through either qualitative or quantitative methods were included, i.e., the mixed method synthesis permitted the inclusion of either qualitative or quantitative findings. Article quality was evaluated by three authors using the Joanna Briggs Institute's critical appraisal tools.
A total of 15 studies - two trials, eight quasi-experimental studies, four qualitative, and one mixed method met the inclusion criteria. The described interventions were organized into five categories: educational/informational; family involvement in care; diary; communication; and bundled interventions. These categories varied in terms of elements, delivery, and family outcomes. Nurse-led interventions that resulted in small to medium improvements in family outcomes included educational interventions with digital storytelling, a bundled approach, informational nursing interventions, and nurse-driven emotional support. The included studies (n = 2) that investigated family rounds in the ICU reported that this approach did not noticeably influence family outcomes.
The differences in the intervention elements, tools, and outcomes evaluated in this review reflect the diversity of family needs, and that numerous interventions have already been developed to promote family health in critical care settings. The evidence suggests that interdisciplinary nurse-led family interventions can improve family outcomes. Tweetable abstract: Interprofessional nurse-led family interventions draw on diverse approaches and improve family outcomes in adult critical care settings.
COVID-19 大流行使患者入住重症监护病房的后果更加严重，导致患者家属面临比以往更多的心理社会问题。因此，护士和其他临床医生需要了解支持重症监护患者家属的干预措施。
提供护士主导的家庭干预及其在成人重症监护病房中对家庭影响的证据。
按照系统评价和荟萃分析报告清单进行的混合方法系统评价。
该搜索包括对相关数据库（PubMed、Scopus、护理与联合健康文献累积索引和 Cochrane 图书馆）的筛选以及相关文章中的引用筛选。研究于 2020 年 10 月 20 日对数据库进行了最终搜索。
使用 Rayyan 软件进行筛选和资格评估。纳入描述护士主导的干预措施对成人重症监护病房家庭影响的研究，无论使用定性或定量方法，即混合方法综合允许纳入定性或定量研究结果。三位作者使用 Joanna Briggs 研究所的批判性评估工具评估文章质量。
共有 15 项研究符合纳入标准 - 两项试验、八项准实验研究、四项定性研究和一项混合方法研究。描述的干预措施分为五类：教育/信息；家庭参与护理；日记；沟通；和综合干预。这些类别在要素、实施和家庭结果方面有所不同。导致家庭结果小到中等改善的护士主导干预措施包括数字故事教育干预、综合方法、信息护理干预和护士驱动的情感支持。本综述中纳入的（n=2）研究报告称，ICU 中的家庭查房并未显著影响家庭结果。
本综述中评估的干预要素、工具和结果的差异反映了家庭需求的多样性，并且已经开发了许多干预措施来促进重症监护病房的家庭健康。证据表明，多学科护士主导的家庭干预措施可以改善家庭结果。可推文摘要：跨专业护士主导的家庭干预措施利用多种方法，可改善成人重症监护病房的家庭结果。
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