目的 系统评价ICU日记对重症患者及家属心理认知、生活质量的影响.方法 计算机检索PubMed、Embase、Web of Science、Cochrane Library、PsycINFO、CNKI、WanFang Data 和 VIP 数据库,搜集与研究目的相关的研究,检索时限均为建库至2023年8月.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入17项研究,包括2 093例患者,786例家属.Meta分析结果显示,与对照组相比,ICU日记能够有效降低患者创伤后应激障碍[RR=0.64,95％CI(0.50,0.83),P＜0.01]和抑郁的发生率[RR=0.65,95％CI(0.48,0.89),P＜0.01],提高患者生活质量[MD=7.78,95％CI(4.37,11.18),P＜0.01],但对患者焦虑、记忆及家属心理影响尚无显著影响.结论 当前证据显示,ICU日记可以降低患者出ICU后创伤后应激障碍、抑郁的发生率,提高患者生活质量,但对患者家属的影响还需要更进一步的研究来确定.受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证.
Efficacy of intensive care unit diaries on patients and relatives:a meta-analysis
Objective To systematically review the efficacy of ICU diaries on psychological outcomes,cognition and health-related quality of life in both patients and their relatives.Methods The PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CNKI,WanFang Data and VIP database were electronically searched to collect trails related to the objective from inception to August 2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.3 software.Results A total of 17 studies involving 2 093 patients and 786 relatives were included.The results of meta-analysis showed that compared with the control group,ICU diaries could improve patients'post-traumatic stress disorder(PTSD)(RR=0.64,95％CI 0.50 to 0.83,P＜0.01),depression(RR=0.65,95％CI 0.48 to 0.89,P＜0.01)and quality of life(MD=7.78,95％CI 4.37 to 11.18,P＜0.01)significantly.However,there were no significant differences in patients'anxiety,memory and relatives'psychological outcomes.Conclusion Current evidence shows that the use of ICU diaries can reduce the incidence rate of patients'PTSD,depression and improve their quality of life,but other effects are unclear.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.
Intensive care unitsICU diariesPost-traumatic stress disorderQuality of lifeMeta-analysisSystematic review
万方数据
维普
