优化严重疾病后的康复:对家庭干预措施的系统审查
Alicia F Holod1, JiYeon Choi2, Judith Tate3
1The Ohio State University College of Nursing, Martha S. Pitzer Center for Women, Children and Youth, 1585 Neil Avenue, Columbus, OH, 43210, USA.
Home health care management & practice
|February 14, 2025
概括
对重症监护室 (ICU) 幸存者的家庭康复干预显示出不同的结果. 需要更多的研究来确定这些ICU后治疗对改善身体,心理和认知恢复的有效性.
科学领域:
- 临界护理医学 临界护理医学
- 康复科学 康复科学 康复科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 每年,大约有500万美国人被送往重症监护室 (ICU).
- 重症监护室的幸存者经常经历长期的身体,心理和认知障碍,这些障碍被统称为重症监护后综合征 (PICS).
- 基于家庭的干预措施被提议作为管理ICU后病情的潜在解决方案,但其有效性的证据有限.
研究的目的:
- 系统地审查和综合评估成年ICU幸存者的家庭康复干预措施的研究结果.
- 评估各种家庭干预措施对身体功能,心理健康,认知功能,生活质量和ICU出院后医疗保健利用的有效性.
主要方法:
- 在主要数据库 (MEDLINE,CINAHL,EMBASE,APA PsycINFO,Google Scholar) 中进行了全面的文献搜索.
- 包含的研究是2010年以后以英语出版的随机对照试验 (RCT) 或准实验设计,重点关注退院的成年ICU幸存者.
- 九项研究符合纳入标准,检查了面对面,基于网络,电话或自我指导的活动等干预措施.
主要成果:
- 纳入的9项研究对在家进行ICU后干预的有效性提出了不同的或不确定的结论.
- 参与者的样本大小各不相同 (21-386),大多数人在ICU期间接受机械通风.
- 干预包括一系列模式,包括面对面的访问,数字平台和指导的自我管理策略.
结论:
- 目前关于家庭康复对ICU幸存者的疗效的证据有限且不确.
- 进一步进行高质量的研究,包括严格的RCT,对于开发和验证有效的家庭干预措施来治疗ICU后的康复至关重要.
- 未来的研究应该考虑更广泛的范围,可能包括术语后重症监护综合征,并探索超越大流行前时代的干预措施.
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