Jiaqi Li , Yingying Fan , Ruoyu Luo , Yangyang Wang , Na Yin , Wenhao Qi , Tiancha Huang , Ju Zhang , Jiyong Jing
{"title":"家庭参与预防重症患者谵妄：系统回顾与荟萃分析","authors":"Jiaqi Li , Yingying Fan , Ruoyu Luo , Yangyang Wang , Na Yin , Wenhao Qi , Tiancha Huang , Ju Zhang , Jiyong Jing","doi":"10.1016/j.ijnurstu.2024.104937","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.</div></div><div><h3>Results</h3><div>This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = −<!--> <!-->2.18, 95 % CI = −<!--> <!-->4.14 to −<!--> <!-->0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = −<!--> <!-->1.46, 95%CI = −<!--> <!-->2.43 to −<!--> <!-->0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.</div></div><div><h3>Conclusions</h3><div>Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.</div></div><div><h3>Registration</h3><div>The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104937"},"PeriodicalIF":7.5000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Family involvement in preventing delirium in critically ill patients: A systematic review and meta-analysis\",\"authors\":\"Jiaqi Li , Yingying Fan , Ruoyu Luo , Yangyang Wang , Na Yin , Wenhao Qi , Tiancha Huang , Ju Zhang , Jiyong Jing\",\"doi\":\"10.1016/j.ijnurstu.2024.104937\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.</div></div><div><h3>Results</h3><div>This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = −<!--> <!-->2.18, 95 % CI = −<!--> <!-->4.14 to −<!--> <!-->0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = −<!--> <!-->1.46, 95%CI = −<!--> <!-->2.43 to −<!--> <!-->0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.</div></div><div><h3>Conclusions</h3><div>Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.</div></div><div><h3>Registration</h3><div>The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).</div></div>\",\"PeriodicalId\":50299,\"journal\":{\"name\":\"International Journal of Nursing Studies\",\"volume\":\"161 \",\"pages\":\"Article 104937\"},\"PeriodicalIF\":7.5000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Studies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020748924002505\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Studies","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020748924002505","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Family involvement in preventing delirium in critically ill patients: A systematic review and meta-analysis
Background
Humanized care is a novel concept in the prevention of delirium, with family involvement being a crucial component. Currently, there is controversy regarding the effectiveness of family involvement in preventing delirium among critically ill patients, and the impact of varying levels of family involvement on delirium prevention remains unclear.
Objective
The purpose of this study is twofold: (a) to investigate the influence of family involvement on delirium among critically ill patients, and (b) to explore the effectiveness of different levels of family involvement in preventing delirium in these patients.
Design
A systematic review and meta-analysis.
Methods
From database inception to July 2024, a comprehensive search was conducted across PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane CENTRAL database. Randomized controlled trials that examined family involvement were included in the review.
Results
This review included a total of 11 randomized controlled trials, encompassing 3113 critically ill patients. Family involvement was found to significantly reduce the incidence of delirium among critically ill patients (RR = 0.46, 95%CI = 0.31 to 0.69), decrease the duration of delirium (WMD = − 2.18, 95 % CI = − 4.14 to − 0.22), and shorten the length of Intensive Care Unit (ICU) stay (WMD = − 1.46, 95%CI = − 2.43 to − 0.50). Three different levels of family involvement—direct participation in care (RR = 0.37, 95%CI = 0.26 to 0.51), family visits and companionship (RR = 0.56, 95 % CI = 0.25 to 1.25), and indirect participation (RR = 0.77, 95 % CI = 0.29 to 2.07)—varies in their effectiveness for delirium prevention.
Conclusions
Family involvement significantly impacts delirium prevention in critically ill patients. The effectiveness of delirium prevention varies depending on the level of family involvement, with direct participation of family members in caregiving demonstrating a more pronounced effect in reducing delirium incidence among critically ill patients.
Registration
The review protocol has been registered in the PROSPERO International prospective register of systematic reviews (CRD42024563095).
期刊介绍：
The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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