The impact of patient- and family-centered care interventions on intensive care unit outcomes: a meta-analysis of randomized controlled trials
O impacto das intervenções de cuidados centrados no paciente e na família nos resultados da unidade de terapia intensiva: uma meta-análise de ensaios clínicos randomizados
Yangjin LV, Peng Li, Ronghui Li, Ting Zhang, Kaifang Cai
Abstract
Background
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).
Methods
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 FamilyCentered 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.
Results
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.
Conclusions
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.
Keywords
Resumo
Introdução
As intervenções de Cuidados Centrados no Paciente e na Família (CCPF) são cada vez mais reconhecidas como uma abordagem viável para abordar vários problemas de saúde mental entre pacientes em Unidades de Terapia Intensiva (UTIs). Portanto, esta revisão visa estimar o efeito das Intervenções de Cuidados Centrados no Paciente e na Família em resultados específicos em pacientes adultos internados em Unidades de Terapia Intensiva (UTIs).
Métodos
Pesquisamos sistematicamente quatro grandes bancos de dados para Ensaios Clínicos Randomizados (RCTs) de braço paralelo. A estrutura PRISMA foi usada para relatar nossa revisão. Incluímos estudos envolvendo pacientes adultos (> 18 anos) admitidos em UTIs e examinamos os efeitos de qualquer tipo de intervenção de Cuidados Centrados no Paciente e na Família (CCPF) em resultados como depressão, ansiedade, delírio e tempo de internação hospitalar. A extração de dados foi realizada de forma independente por dois autores no Medline, Google Scholar e ScienceDirect, desde o início até julho de 2024. O modelo de efeitos aleatórios foi usado para reunir os dados.
Resultados
Um total de 11 estudos foram incluídos em nossa revisão sistemática e meta-análise, com um tamanho de amostra combinado de 3352 pacientes (grupo CCPF, n = 1681; grupo de cuidados habituais, n = 1671). Um modelo de efeitos aleatórios revelou uma redução significativa na prevalência de delírio no grupo CCPF, com uma Razão de Risco (RR) combinada de 0,54 (IC 95% 0,36 a 0,81). No entanto, nenhuma significância estatística foi encontrada para outros resultados, como depressão, tempo de internação na UTI e ansiedade. É importante observar que todos os estudos incluídos foram avaliados como tendo risco alto ou incerto de viés.
Conclusão
As intervenções do CCPF podem reduzir significativamente as taxas de delírio entre pacientes de UTI; no entanto, seus efeitos em outros resultados, como depressão, ansiedade e tempo de internação, não foram estatisticamente significativos.
Palavras-chave
References
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Submitted date:
01/08/2024
Accepted date:
11/09/2024
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