Background

Surviving critical illness can result in ongoing psychological, physical and cognitive impairments for both survivors and families. During the time from the critical illness through to the period of adaptation back to community living, families, alongside survivors, have support needs.

Objectives

This systematic review aimed to provide an in-depth insight into the expressed support needs of families of adults who survived an admission to an intensive care unit and returned to a home environment. It also aimed to explore how these needs change over time, and what support provisions families perceived to be helpful.

Methods

This was a systematic review using thematic synthesis methodology. Predefined searches were conducted in CINAHL, Medline, PsychINFO, SocIndex, EMbase, Academic Search Complete, EThOS and OpenGrey to locate studies published in English from 2000. Two reviewers screened each study against the inclusion criteria. Quality appraisal was undertaken using Joanna Briggs Institute tools. Extracted data were managed in Nvivo12® and analysed to identify descriptive and analytical themes. The Timing it Right Framework was used to frame changes in need across the recovery continuum.

Results

Thirty-nine studies were included, 30 qualitative, eight quantitative and one mixed methods. Five key family needs were identified across the recovery continuum: for security; to make sense of the situation; finding a balance; holding everything together; and for trust.

Discussion

Families found the following interventions helpful: written information; care coordination and navigation; input from intensive care staff after discharge to support continuity; and provision of family support groups. Although there are similarities between the needs of families and survivors, there are sufficient differences to warrant the development of processes to identify and address family need throughout the recovery continuum.

Conclusion

More research is required to develop a tool to better identify the needs of families across the recovery continuum, identify gaps in current service provision, and design interventions to meet these needs.

Study registration: CRD42019136883 (PROSPERO)

中文翻译：

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罹患重病的成年人家庭表达的支持需求：专题综合

背景

幸存的危重疾病可能导致幸存者和家人持续的心理、身体和认知障碍。在从重病到适应社区生活的这段时间里，家庭和幸存者一起有支持需求。

目标

本系统评价旨在深入了解住进重症监护病房并返回家庭环境的成年人家庭表达的支持需求。它还旨在探索这些需求如何随时间变化，以及家庭认为有帮助的支持条款。

方法

这是使用主题综合方法的系统评价。在 CINAHL、Medline、PsychINFO、SocIndex、EMbase、Academic Search Complete、EThOS 和 OpenGrey 中进行了预定义搜索，以查找 2000 年以来以英语发表的研究。两名审阅者根据纳入标准筛选了每项研究。质量评估是使用乔安娜布里格斯研究所的工具进行的。提取的数据在 Nvivo12® 中进行管理和分析，以确定描述性和分析性主题。时机正确框架用于确定整个恢复过程中需要的更改。

结果

共纳入 39 项研究，其中 30 项定性研究、8 项定量研究和 1 项混合方法。在整个恢复过程中确定了五个关键的家庭需求：安全；了解情况；找到平衡点；把一切都放在一起；和信任。

讨论

家庭发现以下干预措施有帮助： 书面信息；护理协调和导航；出院后重症监护人员的投入以支持连续性；和提供家庭支持小组。尽管家庭和幸存者的需求之间存在相似之处，但存在足够的差异以保证在整个恢复过程中确定和解决家庭需求的过程的发展。

结论

需要更多的研究来开发一种工具，以更好地确定整个恢复过程中家庭的需求，确定当前服务提供的差距，并设计干预措施以满足这些需求。

学习注册：CRD42019136883（PROSPERO）