Effectiveness of decision aids on critically ill patients' outcomes and family members' knowledge, anxiety, depression and decisional conflict: A systematic review and meta‐analysis

Author:

Xing Yana1ORCID,Cai Weixin1,Wang Anxin2,Yuan Yuan3,Zhang Ran1

Affiliation:

1. Nursing Department, Beijing Tiantan Hospital Capital Medical University Beijing China

2. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University Beijing China

3. Intensive Care Unit, Beijing Tiantan Hospital Capital Medical University Beijing China

Abstract

AbstractBackgroundDecision aids (DAs) have been proposed to support patients and families with disease information processing and decision‐making, but their effectiveness for critically ill patients and their families is incompletely understood.AimTo systematically synthesize evidence on the effectiveness of the DAs on the prognosis of critically ill patients and knowledge, anxiety, depression and decisional conflict of their family members.Study DesignSystematic review and meta‐analysis. We conducted a systematic search of literature using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature database, Scopus, PsycNet, CNKI and Wanfang Database from the inception of the databases until May 2023 to identify randomized clinical trials (RCTs) describing DAs interventions targeted at adult intensive care unit (ICU) patients or their families. We also searched grey literature in four databases: Chinese Clinical Trials Registry, Chinese Cochrane Center, Open Grey and GreyNet International.ResultsSeven RCTs were included in the review. Meta‐analysis identified longer hospital length of stay (LOS) among all patients compared with usual care (mean difference [MD] = 5.64 days, 95% confidence interval, CI [0.29, 10.98], p = .04), but not in surviving patients (MD = 2.09 days, 95% CI [−3.70, 7.89], p = .48). However, there was no evidence of an effect of DAs on hospital mortality (RR = 1.25, 95% CI [0.92, 1.70], p = .15), ICU LOS (MD = 3.77 days, 95% CI [−0.17, 7.70], p = .06) and length of mechanical ventilation (MD = 0.88 days, 95% CI [−2.22, 3.97], p = .58). DAs led to a statistically significant improvement in family members' knowledge (standard mean difference = 0.84, 95% CI [0.12, 1.56], p = .02). We found no significant effect of DAs on anxiety, depression, post‐traumatic stress disorder, decisional conflict and quality of communication of family members.ConclusionsThis review provides effective evidence that DAs can potentially improve the knowledge level of family members while prolonging the hospital LOS among critically ill patients.Relevance to Clinical PracticeWell‐designed large‐scale studies with DAs tailored to the individuals' preferences and existing cultural values are warranted.

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3