Research and Development Department, North Bristol NHS Trust, Westbury On Trym, Bristol, UK.
Research and Development Department, North Bristol NHS Trust, Westbury On Trym, Bristol, UK.
Intensive Crit Care Nurs. 2024 Oct;84:103768. doi: 10.1016/j.iccn.2024.103768. Epub 2024 Jul 29.
Family members of Intensive Care Unit (ICU) patients can experience mental health difficulties. These are collectively described as Post Intensive Care Syndrome-Family (PICS-F). There are no standardised outcome measures to benchmark the impact of PICS-F. This scoping review aimed to map and characterise interventions, outcomes, and outcome instruments related to PICS-F.
Eight databases were searched in June 2023: Pubmed, CINAHL, Ovid Medline, EMBASE, PsycInfo, AMED, Emcare and Cochrane. The grey literature was also searched. Studies published after 2012 related to PICS-F were included. Search strategy included: (Population) family members of adult ICU patients, (Concept) PICS-F, (Context) ICU settings. Frequency analysis of outcomes was performed, and instruments were mapped to describe the characteristics.
Of the identified 4848 records, 46 papers representing 44 unique studies met the inclusion criteria and were retained for analysis. In total, 8008 family members were represented across 15 countries in four continents worldwide. The number of studies reporting PICS-F interventions increased rapidly over the past 12 years and were performed in ICUs treating mixed conditions. Studies were randomised control trials (n = 33), before-and-after design (n = 6) and non-randomised trials (n = 5). A total of 18 outcome instruments were used measuring predominantly anxiety, with complicated grief measured only once. The identified instruments were mostly validated for clinical and disease specific populations but not validated among relatives of ICU patients.
There is a plethora of instruments measuring PICS-F outcomes. No core outcome set is currently available for PICS-F. To reduce heterogeneity of how PICS-F is measured, a core outcome set with validated measurements is recommended to allow benchmarking and to document the impact of PICS-F interventions.
Recognising PICS-F symptoms and understanding how to assess them could help clinicians to develop interventions to improve family outcomes. Validated instruments are needed to evaluate these interventions.
重症监护病房（ICU）患者的家属可能会经历心理健康问题。这些问题被统称为 ICU 后综合征-家庭（PICS-F）。目前还没有标准化的结果测量方法来衡量 PICS-F 的影响。本范围综述旨在绘制和描述与 PICS-F 相关的干预措施、结果和结果测量工具。
2023 年 6 月，在 8 个数据库中进行了搜索：PubMed、CINAHL、Ovid Medline、EMBASE、PsycInfo、AMED、Emcare 和 Cochrane。还搜索了灰色文献。纳入了 2012 年后发表的与 PICS-F 相关的研究。搜索策略包括：（人群）成人 ICU 患者的家属，（概念）PICS-F，（背景）ICU 环境。对结果进行了频率分析，并对工具进行了映射以描述其特征。
在确定的 4848 条记录中，有 46 篇论文代表 44 项独特的研究符合纳入标准并被保留用于分析。共有来自全球四大洲 15 个国家的 8008 名家属参与了研究。在过去 12 年中，报告 PICS-F 干预措施的研究数量迅速增加，并且在治疗多种疾病的 ICU 中进行。研究设计包括随机对照试验（n=33）、前后设计（n=6）和非随机试验（n=5）。共使用了 18 种工具来测量主要是焦虑，只有一次测量了复杂悲痛。确定的工具主要针对临床和疾病特定人群进行了验证，但未针对 ICU 患者的家属进行验证。
目前有很多测量 PICS-F 结果的工具，但没有针对 PICS-F 的核心结果集。为了减少如何测量 PICS-F 的异质性，建议使用经过验证的测量方法制定核心结果集，以进行基准测试并记录 PICS-F 干预措施的影响。
认识到 PICS-F 症状并了解如何评估它们可以帮助临床医生制定干预措施来改善家庭结果。需要经过验证的工具来评估这些干预措施。
