The effectiveness of interventions to meet family needs of critically ill patients in an adult intensive care unit: a systematic review.
Background Attending to the needs of family members of critically ill patients is an important and necessary step in providing appropriate care for both the patient and the family. An initial search of the Cochrane and Joanna Briggs Institute Libraries did not reveal any published systematic reviews recommending effective interventions for addressing family needs of critically ill patients in an acute intensive care unit.Objectives This systematic review aims to establish best practice in addressing the needs of family members with a relative admitted to an adult critical care unit.Search strategy An extensive search of the major databases was conducted. Databases searched included: MEDLINE, CINAHL, psycINFO, Health source, Web of science, EMBASE, the Cochrane library and Database of abstracts of reviews of effects (DARE) as well as Pubmed. The search included published and unpublished studies and papers in English from 1980-2010.Selection criteria This review considered any randomised controlled trials that evaluated the effectiveness of interventions in addressing family needs of critically ill patients in an adult intensive care unit. In the absence of randomised controlled trials, other research designs such as quasi-experimental as well as before and after studies were considered for inclusion in the narrative summary to enable the identification of current approaches and possible future strategies for addressing family needs of critically ill patients.Assessment of quality Each included study was assessed by two independent reviewers using the appropriate appraisal checklist developed by the Joanna Briggs Institute.Data collection and analysis Data was extracted from the papers included in this review using standardised data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument package. The studies included in this review were not suitable for meta-analysis and therefore the results are presented in narrative form.Results Fourteen studies and one dissertation met the inclusion criteria and were included in the review. There were 12 quasi-experimental studies identified including 8 two or three group, pre-test/post-test studies; 1 one-way between subjects design; 1 interrupted time series and 1 two-group comparative design study. The dissertation was a quasi-experimental three group pre-test/post-test design. There were 3 prospective randomised trials included. The evidence identified includes: the use of support groups for family members of patients admitted to an intensive care unit, structured communication and/or education programs for family members, the use of leaflets or brochures to meet family information needs and open or more flexible visiting hours.Conclusion/Recommendations This review makes several recommendations for clinical practice to address family needs of patients admitted to a critical care unit, however this review highlights the need for significant further research in this area. Future intervention studies focusing on family needs could include: the use of technology such as DVD's and SMS for informing families and interventions specifically designed to improve family comfort.
1. Nursing Research Centre/Queensland Centre for Evidence Based Nursing, Mater Health Services, South Brisbane, Queensland, Australia: a collaborating centre of the Joanna Briggs Institute 2. School of Nursing, Queensland University of Technology, Kelvin Grove Campus, Brisbane, Queensland, Australia.
Kate
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Kynoch
Anne M
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Chang
Fiona
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Coyer