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The effects of intensive care unit-initiated transitional care interventions on elements of post-intensive care syndrome: A systematic review and meta-analysis.

Authors
  • Johanna Josepha Op't Hoog, Sabine Adrian...1
  • Eskes, Anne Maria2
  • Johanna van Mersbergen-de Bruin, Mariëll...3
  • Pelgrim, Thomas4
  • van der Hoeven, Hans5
  • Vermeulen, Hester6
  • Maria Vloet, Lilian Christina7
  • 1 Department of Intensive Care, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands; Research Department of Emergency and Critical Care, HAN University of Applied Science, Nijmegen, the Netherlands. Electronic address: [email protected] , (Netherlands)
  • 2 Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia. , (Australia)
  • 3 Department of Education and Training, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands. , (Netherlands)
  • 4 Research Department of Emergency and Critical Care, HAN University of Applied Science, Nijmegen, the Netherlands. , (Netherlands)
  • 5 Radboud University Medical Centre, Intensive Care Unit, the Netherlands. , (Netherlands)
  • 6 Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, the Netherlands; Research Department of Emergency and Critical Care, HAN University of Applied Science, Nijmegen, the Netherlands. , (Netherlands)
  • 7 Research Department of Emergency and Critical Care, HAN University of Applied Science, Nijmegen, the Netherlands; Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, the Netherlands; Foundation Family and Patient Centered Intensive Care, Alkmaar, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
Publication Date
May 01, 2022
Volume
35
Issue
3
Pages
309–320
Identifiers
DOI: 10.1016/j.aucc.2021.04.010
PMID: 34120805
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of the study was to assess the effectiveness of intensive care unit (ICU)-initiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICS--F). This is a systematic review and meta-analysis SOURCES: The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020. We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Two authors conducted selection, quality assessment, and data extraction and synthesis independently. Outcomes were described using the three elements of PICS, which were categorised into (i) physical impairments (pulmonary, neuromuscular, and physical function), (ii) cognitive impairments (executive function, memory, attention, visuo-spatial and mental processing speed), and (iii) psychological health (anxiety, depression, acute stress disorder, post-traumatic stress disorder, and depression). From the initially identified 5052 articles, five studies were included (i.e., two randomised controlled trials and three nonrandomised controlled trials) with varied transitional care interventions. Quality among the studies differs from moderate to high risk of bias. Evidence from the studies shows no significant differences in favour of transitional care interventions on physical or psychological aspects of PICS-(F). One study with a nurse-led structured follow-up program showed a significant difference in physical function at 3 months. Our review revealed that there is a paucity of research about the effectiveness of transitional care interventions for ICU patients with PICS. All, except one of the identified studies, failed to show a significant effect on the elements of PICS. However, these results should be interpreted with caution owing to variety and scarcity of data. CRD42020136589 (available via https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020136589). Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

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