BackgroundMemory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient’s factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives.MethodsTwo authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality (“Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)” for cohort studies and the “Cochrane Risk of Bias tool” for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies.ResultsSeven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23–0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79–19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression.Conclusion and relevanceThis systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients.Trial registrationPROSPERO, CRD42019136639

中文翻译：

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重症监护病房日记对患者和亲属结果的影响：系统评价和荟萃分析

背景重症监护病房 (ICU) 幸存者的记忆缺失与精神疾病有关。ICU日记提高了患者对ICU的真实记忆，但是否能降低患者及家属出院后精神疾病的发生率尚不清楚。本研究的目的是评估关于 ICU 日记对入住 ICU 的患者及其亲属的影响的文献。 方法 两位作者独立检索了在线数据库 PubMed、OVID、Embase、EBSCO host 和 PsycINFO 从开始到 2019 年 7 月。如果将干预组（ICU 日记）与没有日记的组进行比较，并且样本包括在 ICU 入住 24 小时以上的≥18 岁患者及其亲属，则包括在内。随机临床试验、观察性研究、原始数据信函、并包括摘要，无论语言如何。搜索不受任何特定结果的限制。没有对照组的评论文章、评论、社论和研究被排除在外。结构化工具用于评估方法学质量（队列研究的“非随机干预研究（ROBINS-I）中的偏倚风险”和纳入的 RCT 和前后研究的“Cochrane 偏倚风险工具”）。考虑到研究之间的预期变异性，采用随机效应模型。结果 确定了 785 个标题进行筛选。在参考文献检索后又选择了两项研究，经过全文审查，共纳入了 12 项研究。汇总结果时，ICU 日记与较低的抑郁风险相关（RR 0.41，95% CI 0.23–0. 75) 和更好的生活质量（SF-36 一般健康评分高 10.3 分，95% CI 0.79-19.8），而焦虑或创伤后应激障碍 (PTSD) 没有减少。对于接受 ICU 日记的亲属，PTSD、焦虑或抑郁的发生率没有差异。结论和相关性本系统评价和荟萃分析支持使用 ICU 日记来降低抑郁风险并保持生活质量ICU入院后的患者。ICU 日记似乎对患者亲属没有任何有益影响。试验注册PROSPERO，CRD42019136639 焦虑或抑郁。结论和相关性 本系统评价和荟萃分析支持使用 ICU 日记来降低患者在入住 ICU 后患抑郁症的风险并保持其生活质量。ICU 日记似乎对患者亲属没有任何有益影响。试验注册PROSPERO，CRD42019136639 焦虑或抑郁。结论和相关性 本系统评价和荟萃分析支持使用 ICU 日记来降低患者在入住 ICU 后患抑郁症的风险并保持其生活质量。ICU 日记似乎对患者亲属没有任何有益影响。试验注册PROSPERO，CRD42019136639