The effects of structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions: A randomized controlled study

Abstract

Objectives

This study aims to evaluate the effect of a structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions.

Design

A three-arm parallel, single-blinded, randomized controlled trial was designed.

Research methodology

Patients were randomly assigned to one of three groups: structured family auditory stimulation (Group A), unstructured family auditory stimulation (Group B), and usual care (Group C). The primary outcome was delirium incidence, and secondary outcomes included delirium severity, delirium duration, delirium-free days, delirium subtypes, time to first delirium, the family anxiety and depression levels.

Results

A total of 213 patients were randomly assigned to three groups. There were no significant differences in demographic or clinical characteristics among the three groups. For the primary outcome, fewer patients developed delirium in Group A than in Group B and Group C (22.5 % vs. 26.8 % vs. 49.3 %, P = 0.001). For secondary outcomes, Group A had lower delirium severity scores than the other groups did (3.1 ± 0.4 vs. 4.0 ± 0.3 vs. 5.1 ± 0.3, P < 0.001). Patients in Group A had shorter delirium durations (2.0 vs. 3.0 vs.4.0 days, P < 0.001) and longer delirium-free days (3.0 vs. 2.0 vs. 1.0 days, P < 0.001) than those in Group B and Group C. The time to first delirium was 3.0, 2.0, and 2.0 days, respectively (P < 0.001). The SAS scores of the families in the three groups were 47.1 ± 5.7, 48.9 ± 5.5, and 56.5 ± 7.5 (P < 0.001) and the SDS scores were 38.2 ± 5.8, 38.3 ± 5.7, and 42.7 ± 7.2 (P < 0.001).

Conclusions

The results revealed that structured family auditory stimulation could reduce delirium incidence, decrease its severity, shorten the duration of delirium, increase delirium-free days, and prolong the time to first delirium among ICU patients with unplanned admission. Additionally, it could alleviate families’ anxiety and depression levels.

Implications for clinical practice

Structured family auditory stimulation prevents ICU delirium by maintaining the patients’ cognitive function and promoting early recovery, showing significant clinical potential in ICU delirium.