Ryu Seang, Kim Yun-Hee, Kim Nam Young
Department of Nursing, Mokpo National University, 1666 Yeongsan-ro, Cheonggye-myeon, Muan 58554, Korea.
Department of Nursing, Jungwon University, Munmu-ro, Goesan-eup, Guesan-gun, Chunbuk, Korea.
Iran J Public Health. 2022 Aug;51(8):1741-1754. doi: 10.18502/ijph.v51i8.10256.
ICU patients typically experience diverse kinds of distress factors, which make them vulnerable to delirium thereby resulting in a higher rate of delirium occurrence. We aimed to review systematically current states of preventive nursing intervention in ICUs, and to analyze delirium occurrence and the length of ICU stay to provide suggestions for the preventive nursing practice in ICU.
Data collection was done with literature search databases including PubMed, Ovid-MEDLINE, EMBASE, CINAHL, KMbase, KoreaMed, Korean Studies Information Service System (KISS), Korea Institute of Science and Technology Information (KiSTi), Research Information Service System (RISS) and with hand searching, from Apr 20 to May 10, 2020. Two researchers independently selected research literature, and three researchers summarized and identified related variables based on data extraction methods.
Overall, 236 articles identified, 11 articles met the inclusion criteria for review. The systematic review of the contents of preventive nursing intervention other than drug administration rendered the four types of intervention. The Peto odds ratio (OR) of the rate of delirium occurrence appeared as 0.29 (95% Confidence Interval (CI)=0.20∼0.43) which was statistically significant (=6.23, <.01) in both group. The magnitude of the effect for the length of ICU stay demonstrated insignificant values, Mean difference () -0.23 (95% =-0.51∼0.05) (=1.60, =.11).
For management of delirium among ICU patients, multi-component intervention packages, suitable for care setting in ICUs, need to be taken into account for the preparation of nursing intervention for prevention of delirium applicable to nursing practices.
重症监护病房（ICU）患者通常会经历多种困扰因素，这使他们易患谵妄，从而导致谵妄发生率较高。我们旨在系统回顾ICU预防性护理干预的现状，并分析谵妄的发生情况及ICU住院时间，为ICU的预防性护理实践提供建议。
于2020年4月20日至5月10日，通过文献检索数据库（包括PubMed、Ovid-MEDLINE、EMBASE、CINAHL、KMbase、KoreaMed、韩国研究信息服务系统（KISS）、韩国科学技术信息研究所（KiSTi）、研究信息服务系统（RISS））以及手工检索进行数据收集。两名研究人员独立筛选研究文献，三名研究人员根据数据提取方法总结并确定相关变量。
总共识别出236篇文章，11篇文章符合纳入综述的标准。对除药物治疗外的预防性护理干预内容进行系统综述得出了四种干预类型。谵妄发生率的Peto比值比（OR）为0.29（95%置信区间（CI）=0.20∼0.43），两组均具有统计学意义（=6.23，<.01）。ICU住院时间的效应量显示无显著值，平均差（）-0.23（95%=-0.51∼0.05）（=1.60，=.11）。
对于ICU患者谵妄的管理，在制定适用于护理实践的谵妄预防护理干预措施时，需要考虑适合ICU护理环境的多成分干预方案。
