Love Rhoads Sarah, Trikalinos Thomas A, Levy Mitchell M, Amass Timothy
Department of Medicine, Division of Pulmonary Sciences and Critical Care, University of Colorado, Denver, CO, USA.
Departments of Health Services, Policy, and Practice and of Biostatistics, and Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA.
J Crit Care Med (Targu Mures). 2022 Aug 12;8(3):145-155. doi: 10.2478/jccm-2022-0014. eCollection 2022 Jul.
Increasing awareness of the emotional impact of an Intensive Care Unit (ICU) hospitalization on patients and their families has led to a rise in studies seeking to mitigate Post Intensive Care Syndrome (PICS) for both groups. In efforts to decrease symptoms of anxiety and depression, ICUs have implemented a variety of programs to reduce family distress.
We conducted a systematic review of experimental studies which aimed to reduce stress related disorders in family members after the experience of having a patient admitted to the ICU. Multiple databases were searched for randomized controlled trials or nonrandomized comparative trials which targeted family members or surrogate decision makers. A total of 17 studies were identified for inclusion in the review representing 3471 participants.
We describe those interventions which we qualitatively assigned as "not passive," or those which actively engaged the family to express themselves, as more likely to be successful in both the available pediatric and adult literature than interventions which we identified as "passive." Studies which described active engagement of family members demonstrated comparative improvements in symptoms of depression, anxiety, and PTSD, as well as reduced hospital costs in the case of two studies.
This review may serve to aid in the development of future interventions targeted at reducing family stress and PICS following an ICU hospitalization.
人们越来越意识到重症监护病房（ICU）住院治疗对患者及其家属的情绪影响，这导致旨在减轻两组患者的重症监护后综合征（PICS）的研究不断增加。为了减轻焦虑和抑郁症状，ICU实施了各种项目以减轻家属的痛苦。
我们对旨在减少患者入住ICU后家属应激相关障碍的实验性研究进行了系统评价。在多个数据库中检索针对家属或替代决策者的随机对照试验或非随机对照试验。共确定了17项研究纳入评价，涉及3471名参与者。
我们将那些定性为“非被动”的干预措施，即那些积极促使家属表达自己的措施，描述为在现有的儿科和成人文献中比我们确定为“被动”的干预措施更有可能成功。描述家属积极参与的研究显示，抑郁、焦虑和创伤后应激障碍症状有相对改善，在两项研究中还降低了医院成本。
本评价可能有助于未来制定旨在减轻ICU住院后家属压力和PICS的干预措施。
