摘要
目的 系统评价视频探视在重症监护病房(ICU)中的应用效果.方法 计算机检索中国知网、万方数据库、维普数据库、PubMed、EMbase、the Cochrane Library、Web of Science数据库中有关视频探视的随机对照研究、非随机对照研究与队列研究,检索时限为各数据库建库至2023年2月.由2名研究者依据纳入与排除标准独立筛选文献、提取数据并对纳入文献进行质量评价,采用RevMan5.4软件进行Meta分析.结果 最终纳入13个研究.Meta分析结果显示,视频探视组探视后患者焦虑评分变化值(SMD=0.09,95%CI:-0.60～0.78,P=0.79)、患者焦虑发生率(RR=0.52,95%CI:0.11～2.45,P=0.40)、家属焦虑评分(SMD=-0.22,95%CI:-0.69～0.26,P=0.37)、家属焦虑发生率(RR=1.11,95%CI:0.75～1.65,P=0.60)、病房空气细菌培养合格率(RR=1.04,95%CI:0.95～1.14,P=0.39)与非视频探视组比较差异无统计学意义,患者满意率(RR=1.35,95%CI:1.11～1.63,P=0.002)、家属满意度评分(SMD=0.34,95%CI:0.22～0.46,P＜0.001)、家属满意率(RR=1.29,95%CI:1.22～1.35,P＜0.001)、病房物表采样细菌培养合格率(RR=4.18,95%CI:3.32～5.27,P＜0.001)显著高于非视频探视组,患者谵妄发生率(RR=0.71,95%CI:0.54～0.95,P=0.02)、患者感染率(RR=0.35,95%CI:0.15～0.85,P=0.02)显著低于非视频探视组.结论 现有证据表明,视频探视减缓ICU患者及家属焦虑情绪的效果与非视频探视相当;视频探视较非视频探视能显著提升ICU患者及家属满意率,显著降低ICU患者谵妄发生率及感染风险.
Abstract
Objective To systematically evaluate the effect of video visitation on ICU patients and family members.Methods The published randomized and non-randomized controlled trials,cohort studies of video visitation on ICU patients and family members were retrieved from CNKI,Wan Fang Database,VIP,PubMed,EMbase,the Cochrane Library and Web of Science.The retrieval time was from inception to February 2023.Two investigators independently screened the literature based on inclusion and exclusion criteria,extracted data and evaluated the methodological quality of the included literature.RevMan5.4 software was used for meta-analysis.Results A total of 13 articles were included.Meta-analysis results showed that there were no statistically significant differences between the video visitation group and the non-video visitation group in the change values of patients'anxiety scores[SMD=0.09,95%CI(-0.60,0.78),P=0.79],anxiety incidence of patients[RR=0.52,95%CI(0.11,2.45),P=0.40],anxiety scores of family members[SMD=-0.22,95%CI(-0.69,0.26),P=0.37],anxiety incidence of family members[RR=1.11,95%CI(0.75,1.65),P=0.60],qualified rate of culture results of airborne bacteria in ICU wards[RR=1.04,95%CI(0.95,1.14),P=0.39].The satisfaction rate of patients[RR=1.35,95%CI(1.11,1.63),P=0.002],satisfaction scores of family members[SMD=0.34,95%CI(0.22,0.46),P＜0.001],satisfaction rate of family members[RR=1.29,95%CI(1.22,1.35),P＜0.001],qualified rate of culture results of object surface bacteria in ICU wards[RR=4.18,95%CI(3.32,5.27),P＜0.001]were significantly higher in the video visitation group than those in the non-video visitation group.The delirium incidence of patients[RR=0.71,95%CI(0.54,0.95),P=0.02]and infection rate of patients[RR=0.35,95%CI(0.15,0.85),P=0.02]were significantly lower in the video visitation group than those in the non-video visitation group.Conclusions The existing evidence suggests that video visitation was as effective as non-video visitation in reducing anxiety of ICU patients and family members.Compared with non-video visitation,video visitation could significantly improve the satisfaction rate of ICU patients and family members,and significantly reduce the incidence of delirium and the risk of infection of ICU patients.
基金项目
宜春市指导性科技计划项目(2022ZDJH6148)
维普
万方数据