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Intensive Care Based Interventions to Reduce Family Member Stress Disorders: A Systematic Review of the Literature


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Fig 1

Study selection process, based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Study selection process, based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Included Adult Studies with outcome measures by intervention type, Not Passive or Passive

Setting/ Year Author Emotional Outcome Tool mean result, control (95% CI) versus experimental (95% CI) Satisfaction Outcomes Mean Results, control (SD) versus experimental (SD) Resource Utilization Mean Results, control (SD) vs experimental (SD)
Adult- Not Passive STAI HADS PHQ-9 GAD-7 C-DASS IES-r PCL PPPC FSICU-24 LOS: ICU LOS: Hospital Cost of care (thousands)

2018 White D, et al 12.1 (11.54- 12.66) vs 11.7 (11.04­12.36) 20.7 (19.53 - 21.87) vs 1.8 (0.7) vs 20.5 (18.981.6 (0.6) 22.02) 8.8 , (8.229.38) vs 8.1 (7.38- 8.82) ' ' 15.5 (14.23 - 16.77) vs 11.8 (10.7­12.9)

2016 Curtis JR, et al 4.7 vs 2.4 (-0.431-0.43) 2.7 vs 1.8 (-3.11.32) 30.6 vs 27.1 (-7.12- 0.10) 21.4 vs 17.4 (-0.14- 0.46) 32.6 vs 24.1 (0.24- 0.86) ICU: 75.85 vs 51.1 (48.68--0.9) Hospital: 170.7 vs 123.1 (-90.48--4.67)

2007 Lautrette A, et al 17 (IQR 11-25) vs 11 (IQR 8-18) 39 (IQR 25-48) vs 27 (IQR 18-42)

2008 Kloos J and Daly B 39.53 (36.23 - 42.83) vs 40.42 (37.83 - 43.01)

2020 Amass T et al 12.31 (10.94- 13.67) vs 13.16 (12.214.13) 27.2 (23.56- 30.84) vs 12.3 (10.94- 13.67) 85.44 (87.31- 91.95) vs 89.63 (83.14- 87.74)

Adult - Passive

2004 Moreau D, et al Total 21 (ND) vs 22 (ND) Anxiety 13 (ND) vs 9 (ND) Depression 8 (ND) vs 9 (ND)

2016 Carson S, et al Anxiety: 6.4 (5.72 - 7.08) vs 7.2 (6.54 - 7.84) Depression: 5 (4.34- 5.66) vs 4.9 (4.29- 5.51) 25.6 (23 - 28.2) vs 20.7 (18.03-23.37) 81.1 (78.3- 83.9) vs 84.3 (81.387.3)

2017 Chiang V, et al Anxiety: 7.71 (4.92- 10.5) vs 7.23 (4.9-9.56) Depression: 7.94 (4.84- 11.04) vs 6.1 (3.88-8.32)

2016 Garrouste- Orgeas M, et al Anxiety: 8 (IQR 4.5 - 12) vs 4 (IQR 1-9) Depression: 5.5 (IQR 1- 11.5) vs 2 (IQR 0- 6) 24 (ND) vs 21 (ND)

Instruments for measurement of stress and emotional affect

Tool Name Intended Assessment Scale Range Scale Interpretation Population #Questions Style Comments
Parental Stressor Scale (PSS) parent stress, negative feelings about children/ parenting 18-90 higher score indicates greater stress Parents 18 self-reported

Parenting Stress Index (PSI) parent stress, positive and negative feelings about children/ parenting 0-100 higher score indicates greater stress, conflict Parents 101 self-reported

Neonatal Index of Parental Satisfaction (NIPS) infant behavior 0-7 higher score indicates higher levels of satisfaction Parents 30 self-reported

Patient-Health Questionnaire (PHQ-9) Depression 0-27 higher score indicates depression: Stratified according to severity- 0-4 Minimal or none Monitor; may not require treatment 5-9 Mild Use clinical judgment (symptom duration, functional impairment) to determine necessity of treatment 10-14 Moderate 15-19 Moderately severe Warrants active treatment with psychotherapy, medications, or combination 20-27 Severe Adults 9 self-reported

Generalized Anxiety Disorder Scale (GAD-7) Generalized Anxiety Disorder 0-21 higher score indicates greater likelihood of clinically significant anxiety disorder Score Symptom Severity 5-9 Mild Monitor 10*-14 Moderate Possible clinically significant condition >15 Severe Active treatment probably warranted Adults 7 self-reported

Posttraumatic Stress Disorder Checklist (PCL) PTSD 0-80 higher score indicates higher likelihood of PTSD provisional PTSD diagnosis can be made by treating each item rated as 2 = "Moderately" or higher as a symptom endorsed, then following the DSM-5 diagnostic rule which requires at least: 1 B item (questions 1-5), 1 C item (questions 6-7), 2 D items (questions 8-14), 2 E items (questions 15-20). Preliminary validation work is sufficient to make initial cut-point score suggestions, but this information may be subject to change. A PCL-5 cut-point score of 33 appears to be a reasonable value Adults 20 self-reported for civilians and military (not relevant for our study)

Hospital Anxiety and Depression Scales (HADS) Anxiety and Depression 0-21 (for each scale-full HADS provides two separate scales) higher score indicates higher likelihood of generalized anxiety or depression Adults 14 self-reported

State-Trait Anxiety Inventory (STAI) Anxiety and Depression 20-80 (for each State and Trait) higher score indicates higher likelihood of anxiety and stress Adults, Care-givers 40 self-reported 20 trait-focused and 20 state-focused questions. Requires 6th grade reading level

Nurse Parent Support Tool (NPST) parent perceptions of support, stress 1-5 per item higher score indicates higher perceived support Parents 21 self-reported

Impact of Event Scale (IES) subjective distress caused by traumatic events 0-88 higher score indicates higher likelihood of PTSD Adults 22 self-reported

Included Studies with outcome measures by intervention type, Not Passive or Passive

Setting/Year Author Emotional Outcome Tool mean result, control (95% Cl) versus experimental (95% Cl) Satisfication Outcomes Mean Results, control (95% Cl) versus experimental (95% Cl)
Pediatric - Not Passive PSS:NICU PSS NIPS STAI PSI-P NPST

2005 Browne J, Talmi A

2017 Kadivar M, et al 102.2 (94- 110) VS 137 (132- 142)

1988 Curley M 2.66 vs 1.92 (Cl unable to calculate)

2004 Melnyk B, et al 39.1 (36-42.2) vs 36(33.7- 38.3) 7.4(6.12-8.68) vs 5.6(4.76-6.44)

Pediatric - Passive

2011 Franck L, et al 2.57 (2.44- 2.7) VS 2.58 (2.44- 2.72)

2015 Abdel-Latif M, et al 3.47 (3.3- 3.64) VS 3.47(3.26-3.61)

2015 Clarke-Pounder J, et al Anxiety change -4.2 (-6.89-1.51) vs 0.33 (-5.67-6.34)

2013 Weiss J, et al 2.84(2.61-3.07) VS 2.7 (2.52-4.47) 4.16 (3.97-4.35) vs 4.14 (4.01-4.27)
eISSN:
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Inglés
Calendario de la edición:
4 veces al año
Temas de la revista:
Medicine, Clinical Medicine, Internal Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine