Background

The COVID-19 pandemic has exacerbated the consequences of a patient's admission to critical care settings, causing families to face more psychosocial issues than in previous years. Thus, nurses and other clinicians need to keep abreast of interventions that support the families of critical care patients.

Objective

To provide evidence of nurse-led family interventions and their family outcomes in adult critical care settings.

Design

A mixed method systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist.

Data sources

The search included both a screen of relevant databases (PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Library) and the screening of citations in relevant articles. Studies published in the English language between January 2010 and October 2020 were considered. The final database searches were performed on 20 October 2020.

Methods

Screening and eligibility assessment were conducted using the Rayyan software. Studies describing the family outcomes of nurse-led interventions in adult critical care settings through either qualitative or quantitative methods were included, i.e., the mixed method synthesis permitted the inclusion of either qualitative or quantitative findings. Article quality was evaluated by three authors using the Joanna Briggs Institute's critical appraisal tools.

Findings

A total of 15 studies – two trials, eight quasi-experimental studies, four qualitative, and one mixed method met the inclusion criteria. The described interventions were organized into five categories: educational/informational; family involvement in care; diary; communication; and bundled interventions. These categories varied in terms of elements, delivery, and family outcomes. Nurse-led interventions that resulted in small to medium improvements in family outcomes included educational interventions with digital storytelling, a bundled approach, informational nursing interventions, and nurse-driven emotional support. The included studies (n = 2) that investigated family rounds in the ICU reported that this approach did not noticeably influence family outcomes.

Conclusion

The differences in the intervention elements, tools, and outcomes evaluated in this review reflect the diversity of family needs, and that numerous interventions have already been developed to promote family health in critical care settings. The evidence suggests that interdisciplinary nurse-led family interventions can improve family outcomes.

Tweetable abstract: Interprofessional nurse-led family interventions draw on diverse approaches and improve family outcomes in adult critical care settings

中文翻译：

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护士主导的家庭干预改善成人重症监护环境家庭结果的证据基础：混合方法系统评价

背景

COVID-19 大流行加剧了患者进入重症监护机构的后果，导致家庭面临比往年更多的社会心理问题。因此，护士和其他临床医生需要及时了解支持重症监护患者家属的干预措施。

客观的

提供证据表明护士主导的家庭干预及其在成人重症监护环境中的家庭结果。

设计

根据系统评价和荟萃分析清单的首选报告项目进行的混合方法系统评价。

数据源

搜索包括筛选相关数据库（PubMed、Scopus、护理和相关健康文献累积索引以及 Cochrane 图书馆）和筛选相关文章中的引文。考虑了 2010 年 1 月至 2020 年 10 月期间以英语发表的研究。最终数据库搜索于 2020 年 10 月 20 日进行。

方法

使用 Rayyan 软件进行筛选和资格评估。通过定性或定量方法描述成人重症监护环境中护士主导干预的家庭结果的研究被包括在内，即混合方法综合允许包括定性或定量结果。文章质量由三位作者使用 Joanna Briggs Institute 的关键评估工具进行评估。

发现

共有 15 项研究——两项试验、八项准实验研究、四项定性研究和一项混合方法符合纳入标准。所描述的干预措施分为五类：教育/信息；家庭参与护理；日记; 沟通; 和捆绑干预。这些类别在元素、分娩和家庭结果方面各不相同。导致家庭结果小到中等改善的护士主导的干预措施包括数字化讲故事的教育干预、捆绑方法、信息护理干预和护士驱动的情感支持。 调查 ICU 家庭查房的纳入研究 ( n = 2) 报告说，这种方法没有显着影响家庭结果。

结论

本综述中评估的干预要素、工具和结果的差异反映了家庭需求的多样性，并且已经开发了许多干预措施来促进重症监护环境中的家庭健康。证据表明，由护士主导的跨学科家庭干预可以改善家庭结果。

推文摘要：跨专业护士主导的家庭干预利用多种方法并改善成人重症监护环境中的家庭结果