The incidence and risk factors of syndromic psychological dysfunction in family members after ICU: A System review and meta-analysis.

Abstract

Objective To summarize the risk factors of Post Intensive Care unit-family (PICS-F) mental dysfunction in family members, and to provide evidence for clinical medical staff to identify the risk factors of PICS-F mental dysfunction in advance. Methods Embase, PubMed, Cochrane Library, EBSCO, Web of Science, China Biomedical Database (CBM), CNKI, WanFang Database and VIP database were systematically searched from database establishment to May 2022. Literature on the risk factors of PICS-F mental dysfunction was included. After screening, extraction and quality evaluation, stata17.0 and RveMan5.4 were used to conduct meta-analysis on the incidence and risk factors of PICS-F. Results a total of 10692 subjects were included in 15 literatures. The incidence of pics-f mental dysfunction was 28% (95%CI 0.22 to 0.35). Subgroup analysis showed a 30% incidence in the United States and 27% in other countries. The incidence was 26% in cohort studies, and 43% in case-control and cross-sectional studies. The incidence was 26% at 3 months and 13% at 6 months. Meta-analysis results showed patient age (OR=1.06,95%CI 1.01 to 1.10), gender of family members (OR=4.07,95%CI 2.52 to 6.60) and relationship between family members and patients (OR=2.24,95%CI 1.00 to 4.99), family history of mental illness (OR=3.77,95%CI 1.58 to 8.97), length of ICU stay (OR=4.72,95%CI 2.10 to 10.64), and severity of disease (OR=5.95,95%CI 2.09 to 16.94), death (OR=1.90,95%CI 1.31 to 2.77), family education level (OR=1.07,95%CI 1.02 to 1.12) were the influencing factors of PICS-F psychological dysfunction. It is not clear whether the mode of admission and attendance at family meetings have an effect on PICS-F mental dysfunction. Conclusion The risk factors for PICS-F mental dysfunction are young age, female family member, spouse, history of mental illness, long ICU stay, severity of illness, death and low education level of family members. Clinical medical staff should pay attention to the above risk factors and take corresponding measures to reduce the incidence of PICS-F psychological dysfunction. Relevance to clinical practiceThe results of our meta-analysis have important consequences for ICU nurse managers. Our finding of high rate of PICS-F Psychological dysfunction among ICU patients. That more attention should be devoted to develop and apply prevention programs for ICU nurses to manage this global issue.

Family Members’ Feedback on the “Quality of Death” of Adult Patients Who Died in Intensive Care Units and the Factors Affecting the Death Quality: A Systematic Review and Meta-Analysis

“…However, providing adequate end-of-life care in the ICU remains challenging [ 3 ], and a significant number of healthcare professionals involved in intensive care experience difficulties in end-of-life care in the ICU setting [ 4 , 5 ]. Moreover, given that being a family member of a nonviable patient is identified as a risk factor for the occurrence of post-intensive care syndrome-family (PICS-F) in families of ICU patients [ 6 ], end-of-life care in ICUs may be considered inadequate and might not alleviate the psychological burden on the family. However, the influence of the quality of death on PICS-F remains unclear.…”