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重症监护病房谵妄患者的心理干预:一项范围综述方案。

Psychological interventions for patients with delirium in intensive care: A scoping review protocol.

作者信息

Shaikh Madiha, Wade Dorothy M, King Lara, Mackay Liam, Symes Isabelle, Syeda Anam, Greenburgh Anna

机构信息

Clinical Health Psychology, North East London Foundation NHS Trust, United Kingdom.

Research Department of Clinical, Educational and Health, University College London, United Kingdom.

出版信息

PLoS One. 2024 Dec 20;19(12):e0315832. doi: 10.1371/journal.pone.0315832. eCollection 2024.

Abstract

The objective of this scoping review is to investigate psychological interventions developed, evaluated, and considered for patients with delirium in intensive care units (ICU). Data will be extracted from sources of evidence that address interventions for delirium-related distress and/or cognitive impairments in the adult ICU population, suitable for delivery by or under the supervision of a psychological practitioner. ICU delirium is a common and impactful condition that adversely affects patient outcomes, including prolonged hospitalisation and deteriorating mental health. Despite its significance, it remains poorly understood. Addressing the psychological impact of delirium is crucial for improving both short- and long-term psychological outcomes in ICU patients. However, current non-pharmacological interventions often fail to consider this issue. The inclusion criteria encompass psychological interventions for critically ill adults that directly impact their thoughts, feelings, behaviour and/or cognition. Additionally, interventions involving relatives and multi-component non-pharmacological approaches will be considered. The databases Medline (Ovid), PsycINFO (Ovid), Embase (Ovid), and CINAHL Plus will be searched, covering literature from 1990 to the present. We chose 1990 as the earliest time point for searches because psychological input in ICUs began globally around 2000, with notable expansion in the past decade. Reference lists from identified articles will be hand-searched and PsycEXTRA (Ovid) and WorldCat.org will be searched for grey literature. Relevant information will be extracted and reported using a PRISMA flow diagram, characteristics and frequency table as well as narrative descriptions. This review aims to collate evidence to guide the development and evaluation of new psychological interventions to address delirium in the ICU.

摘要

本范围综述的目的是调查为重症监护病房(ICU)中谵妄患者开发、评估和考虑采用的心理干预措施。数据将从针对成年ICU患者谵妄相关痛苦和/或认知障碍干预措施的证据来源中提取,这些证据来源适用于由心理从业者提供或在其监督下实施。ICU谵妄是一种常见且有影响的病症,会对患者的预后产生不利影响,包括住院时间延长和心理健康恶化。尽管其具有重要意义,但人们对它的了解仍然很少。解决谵妄的心理影响对于改善ICU患者的短期和长期心理预后至关重要。然而,目前的非药物干预措施往往没有考虑到这个问题。纳入标准包括直接影响重症成年患者的思想、情感、行为和/或认知的心理干预措施。此外,还将考虑涉及亲属的干预措施和多成分非药物方法。将检索Medline(Ovid)、PsycINFO(Ovid)、Embase(Ovid)和CINAHL Plus数据库,涵盖1990年至今的文献。我们选择1990年作为检索的最早时间点,因为ICU中的心理干预在全球范围内大约从2000年开始,在过去十年中有显著扩展。将手工检索已识别文章的参考文献列表,并检索PsycEXTRA(Ovid)和WorldCat.org以获取灰色文献。将使用PRISMA流程图、特征和频率表以及叙述性描述来提取和报告相关信息。本综述旨在整理证据,以指导开发和评估新的心理干预措施,以解决ICU中的谵妄问题。

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