A systematic review on the effect of telehealth communication with intensive care unit families on patient and family outcomes

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2025-01-01 DOI:10.1016/j.aucc.2024.06.013

Claire Crossfield MNP, RN , Guncag Ozavci PhD, MBA, MSc, BPharm , Robin Digby PhD, RN , Tracey Bucknall PhD, RN, FAAN

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Abstract

Background

During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood.

Objective

The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment.

Review method used

A systematic review of relevant studies was undertaken.

Data sources

Databases included CINAHL, APA PsychINFO, MEDLINE, and Ovid Embase.

Review methods

Databases were searched with a date restriction of June 1st, 2011, to June 1st, 2023. Two independent reviewers assessed each study using the Mixed Methods Appraisal Tool, version 2 of the Cochrane risk-of-bias tool for randomised controlled trials, and the Risk Of Bias In Nonrandomised Studies of Interventions tool for methodological quality and risk of bias. Of the 2292 articles screened, 10 studies met the inclusion criteria.

Results

Ten studies were included (n = 3861). Methodological quality was mostly poor, with one study evaluated as high on Mixed Methods Appraisal Tool quality criteria. Two themes were derived from the literature: (i) patient and family satisfaction; and (ii) patient and family psychological distress symptoms. Five studies reported patient and family satisfaction, with four studies finding statistically significant improvement following the communication intervention. However, only one of the five studies specifically evaluated the satisfaction with the communication intervention. Nine studies reported patient and family psychological distress symptoms, using 12 measurement tools. A variable effect of interventions was found within this theme.

Conclusions

This review identified important gaps in the research examining remote-only family communication interventions in intensive care. Inconsistent delivery of remote-only communication interventions, biased research methods, and variable outcome measurement tools impacted the reliability and validity of current evidence. Further research on remote-only communication interventions and the effect on families is recommended.

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关于与重症监护室家属进行远程医疗沟通对患者和家属治疗效果影响的系统性综述。

背景介绍在 Covid-19 大流行期间，重症监护室的家属探视受到严格限制。作为回应，家属的沟通方式转为只能远程选择。人们对这种沟通方式的改变对患者和家属的影响知之甚少：本综述旨在综合有关仅远程沟通干预措施及其对重症监护环境中患者和家属治疗效果的影响的现有研究：采用的综述方法：对相关研究进行系统综述：数据库包括 CINAHL、APA PsychINFO、MEDLINE 和 Ovid Embase：检索数据库的日期限制为 2011 年 6 月 1 日至 2023 年 6 月 1 日。两位独立审稿人使用 "混合方法评估工具"（Mixed Methods Appraisal Tool）、Cochrane随机对照试验偏倚风险工具第 2 版以及 "非随机干预研究中的偏倚风险"（Risk Of Bias In Non-randomised Studies of Interventions）工具对每项研究进行方法学质量和偏倚风险评估。在筛选出的 2292 篇文章中，有 10 项研究符合纳入标准：结果：共纳入 10 项研究（n = 3861）。方法学质量大多较差，只有一项研究根据混合方法评估工具的质量标准被评为较高。从文献中得出两个主题：(i) 患者及家属满意度；(ii) 患者及家属心理困扰症状。五项研究报告了患者和家属的满意度，其中四项研究发现沟通干预后患者和家属的满意度在统计学上有显著提高。然而，五项研究中只有一项对沟通干预的满意度进行了具体评估。九项研究报告了患者和家属的心理困扰症状，使用了 12 种测量工具。在这一主题中发现了干预措施的不同效果：本综述发现了重症监护中远程家庭沟通干预研究的重要不足。仅远程沟通干预措施的实施方式不一致、研究方法有偏差以及结果测量工具各不相同，这些都影响了当前证据的可靠性和有效性。建议进一步研究纯远程沟通干预措施及其对家庭的影响。

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来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.