Li Lingling, Chen Meng, Yu Ningning, Zhang Qixia
Ward 330, Department of Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Nurs Crit Care. 2025 May;30(3):e13202. doi: 10.1111/nicc.13202. Epub 2024 Oct 28.
Spiritual care interventions can be an important source of emotional support for patients in the intensive care unit (ICU). However, there is wide variation in the literature and no quantitative assessment to synthesize the results of these studies.
To examine the effectiveness of spiritual care interventions on disease-related physiological parameter and treatment outcomes and psychosocial well-being outcomes among patients in the ICU.
A comprehensive search was conducted across 11 databases from inception to 27 May 2024. Studies involving the implementation of spiritual care interventions for patients in the ICU were included. Cochrane's bias risk tool and JBI Critical Appraisal Checklist were used to examine the methodological quality of included studies. Review Manager 5.3 was used to conduct meta-analyses.
A total of 18 studies were included. Meta-analysis showed that spiritual care interventions could significantly reduce mean arterial pressure (MAP) (MD: -12.12, 95% CI: [-23.68, -0.56], p = .04), length of stay in the ICU (MD: -5.49, 95% CI: [-8.99, -2.00], p = .002), and improved consciousness (MD: 3.91, 95% CI: [1.42, 6.39], p = .002), anxiety (SMD: -1.78, 95% CI: [-3.06, -0.50], p = .006), spiritual well-being (SMD: 1.57, 95% CI: [0.05, 3.08], p = .04) and comfort (MD: 15.53, 95% CI: [10.81, 20.25], p < .01) among patients in the ICU, but had no significant effects on heart rate (HR), respiratory rate (RR), pulse rate (PR), blood pressure (BP), oxygen saturation (SpO), duration of ventilator use and pain.
Spiritual care interventions could reduce MAP and length of stay in the ICU; improve consciousness, anxiety, spiritual well-being and comfort among patients in the ICU; and are still inconclusive for HR, RR, PR, BP, SpO, duration of ventilator use and pain. Urgent efforts are needed to better integrate spiritual care interventions into clinical care to enhance patient well-being.
Spiritual care interventions could improve well-being of patients in the ICU.
精神关怀干预可以成为重症监护病房(ICU)患者情感支持的重要来源。然而,文献中存在很大差异,且没有定量评估来综合这些研究的结果。
探讨精神关怀干预对ICU患者疾病相关生理参数、治疗结局及心理社会幸福感结局的有效性。
对11个数据库从创建到2024年5月27日进行全面检索。纳入涉及对ICU患者实施精神关怀干预的研究。使用Cochrane偏倚风险工具和JBI批判性评价清单来检查纳入研究的方法学质量。使用Review Manager 5.3进行荟萃分析。
共纳入18项研究。荟萃分析表明,精神关怀干预可显著降低ICU患者的平均动脉压(MAP)(MD:-12.0,95%CI:[-23.68,-0.56],p = 0.04)、ICU住院时间(MD:-5.49,95%CI:[-8.99,-2.00],p = 0.002),并改善意识(MD:3.91,95%CI:[1.42,6.39],p = 0.002)、焦虑(SMD:-1.78,95%CI:[-3.06,-0.50],p = 0.006)、精神幸福感(SMD:1.57,95%CI:[0.05,3.08],p = 0.04)和舒适度(MD:15.53,95%CI:[10.81,20.25],p < 0.01),但对心率(HR)、呼吸频率(RR)、脉搏率(PR)、血压(BP)、血氧饱和度(SpO)、呼吸机使用时长和疼痛无显著影响。
精神关怀干预可降低ICU患者的MAP和住院时间;改善ICU患者的意识、焦虑、精神幸福感和舒适度;对HR、RR、PR、BP、SpO、呼吸机使用时长和疼痛的影响仍不明确。需要迫切努力将精神关怀干预更好地整合到临床护理中,以提高患者的幸福感。
精神关怀干预可改善ICU患者的幸福感。