Lv Yangjin, Li Peng, Li Ronghui, Zhang Ting, Cai Kaifang
Department of Intensive Care Unit, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China.
Yiyang Medical College Nursing Department, Yiyang, Hunan, China.
Braz J Anesthesiol. 2025 Jan-Feb;75(1):844577. doi: 10.1016/j.bjane.2024.844577. Epub 2024 Nov 26.
Patient and Family-Centered Care (PFCC) interventions are increasingly recognized as a viable approach to address various mental health issues among patients in Intensive Care Units (ICUs). Therefore, this review aims to estimate the effect of Patient and Family-Centered Care Interventions on specific outcomes in adult patients admitted to Intensive Care Units (ICUs).
We systematically searched four major databases for parallel arm Randomized Controlled Trials (RCTs). The PRISMA framework was used to report our review. We included studies involving adult patients (> 18-years) admitted to ICUs and examined the effects of any type of Patient and Family-Centered Care intervention (PFCC) on outcomes such as depression, anxiety, delirium, and length of hospital stay. Data extraction was performed independently by two authors in Medline, Google Scholar, and ScienceDirect, from inception to July 2024. Random effects model was used to pool the data.
A total of 11 studies were included in our systematic review and meta-analysis, with a combined sample size of 3352 patients (PFCC group, n = 1681; usual care group, n = 1671). A random-effects model revealed a significant reduction in delirium prevalence in the PFCC group, with a pooled Risk Ratio (RR) of 0.54 (95% CI 0.36 to 0.81). However, no statistical significance was found for other outcomes such as depression, length of ICU stay, and anxiety. It is important to note that all the included studies were assessed to have either a high or unclear risk of bias.
PFCC interventions may significantly reduce delirium rates among ICU patients; however, their effects on other outcomes, such as depression, anxiety, and length of stay, were not statistically significant.
以患者和家庭为中心的护理（PFCC）干预措施越来越被认为是解决重症监护病房（ICU）患者各种心理健康问题的可行方法。因此，本综述旨在评估以患者和家庭为中心的护理干预措施对入住重症监护病房（ICU）的成年患者特定结局的影响。
我们系统检索了四个主要数据库，以查找平行组随机对照试验（RCT）。采用PRISMA框架报告我们的综述。我们纳入了涉及入住ICU的成年患者（>18岁）的研究，并考察了任何类型的以患者和家庭为中心的护理干预（PFCC）对抑郁、焦虑、谵妄和住院时间等结局的影响。两名作者于2024年7月前在Medline、谷歌学术和科学Direct数据库中独立进行数据提取。采用随机效应模型汇总数据。
我们的系统综述和荟萃分析共纳入11项研究，合并样本量为3352例患者（PFCC组，n = 1681；常规护理组，n = 1671）。随机效应模型显示，PFCC组谵妄患病率显著降低，汇总风险比（RR）为0.54（95%CI 0.36至0.81）。然而，在抑郁、ICU住院时间和焦虑等其他结局方面未发现统计学意义。需要注意的是，所有纳入研究的偏倚风险评估均为高或不明确。
PFCC干预措施可能显著降低ICU患者的谵妄发生率；然而，其对抑郁、焦虑和住院时间等其他结局的影响无统计学意义。
