重症监护室日记对生存患者及家属心理状态和生活质量影响的meta分析

Effect of Intensive Care Unit diary on the psychological status and quality of life in survivors and family members:a meta-analysis

目的评价重症监护室(intensive care unit,ICU)日记对生存患者及家属心理状态和生活质量的影响。方法计算机检索PubMed、MEDLINE、EBSCO、OVID、The Cochrane Library、Proquest、中国知网、万方、维普等数据库ICU日记文献,检索时段为建库至2021年3月。由两名研究者进行文献筛选、资料提取和质量评价,应用RevMan 5.3统计软件进行meta分析。结果共纳入21篇文献,2056例患者,797名家属。Meta分析结果显示,ICU日记能减少重症患者创伤后应激障碍(post traumatic stress disorder,PTSD)(OR=0.55,95%CI:0.41~0.74,P<0.01)和家属PTSD阳性症状(OR=0.34,95%CI:0.18~0.63,P<0.01),改善患者的抑郁程度(OR=0.58,95%CI:0.38~0.90,P=0.01),但对患者的生活质量和焦虑程度改善效果不明显(P>0.05)。ICU日记对减轻家属焦虑和抑郁状况的效果不明确(P>0.05)。结论ICU日记能减少生存患者及其家属PTSD阳性症状,改善患者的抑郁程度;对患者生活质量和焦虑的改善无明显作用,对减轻家属焦虑和抑郁状况的效果不明确。

Objective To evaluate the effect of Intensive Care Unit(ICU)diary on the psychological status and quality of life of survivors and their family members.Methods Randomized controlled trials on the effects of ICU diary on the psychological status and quality of life of survivors and their families were searched on the databases of PubMed,MEDLINE,OVID,Web of science,The Cochrane Library,CNKI,WANFANG,VIP.Time intervals of search were from databases establishment to March 2021 were collected.The literatures were screened by two researchers independently based on inclusion and exclusion criteria.Then data extraction and quality evaluation were performed,and the meta-analysis was performed by RevMan 5.3 software.Results Twenty-one studies with 2056 patients and 797 family members were included.Meta-analysis showed that ICU diary could reduce the incidence of post traumatic stress disorder(PTSD)in survivors(OR=0.55,95%Cl:0.41-0.74,P<0.01)and their family members(OR=0.34,95%CI:0.18-0.63,P<0.01),improve depression(OR=0.58,95%Cl:0.38-0.90,P=0.01).However,there was no significant difference in anxiety and quality of life between the two groups(P>0.05),and the effect of ICU diary on reducing anxiety and depression in family members was unclear.Conclusions ICU diary could reduce the incidence of PTSD in patients and their family members,improve the depression level and quality of life among patients,which has no obvious effect on the improvement of anxiety and quality of life,and the effect on reducing anxiety and depression of family members is unclear.