Stephana J Cherak1, Brianna K Rosgen, Mungunzul Amarbayan, Krista Wollny, Christopher J Doig, Scott B Patten, Henry T Stelfox, Kirsten M Fiest. 1. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada. O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. Faculty of Nursing, University of Calgary, Calgary, AB, Canada. Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Abstract
OBJECTIVES: Determine effect of mental health interventions on psychologic outcomes in informal caregivers of critically ill patients. DATA SOURCES: Searches conducted in MEDLINE, Embase, and other databases from inception to October 31, 2019. STUDY SELECTION: Interventions for informal caregivers of critically ill patients in adult ICU, PICU, or neonatal ICU. DATA EXTRACTION: Two independent, blinded reviewers screened citations and extracted data. Random-effects models with inverse variance weighting pooled outcome data when suitable. Psychologic outcomes categorized: 1) negative (anxiety, depression, post-traumatic stress disorder, distress, and burden) or 2) positive (courage, humanity, justice, transcendence, temperance, and wisdom and knowledge). Stratification according to intervention type and patient population was performed. DATA SYNTHESIS: Of 11,201 studies, 102 interventional trials were included (n = 12,676 informal caregivers). Interventions targeted caregiver experience (n = 58), role (n = 6), or support (n = 38). Meta-analysis (56 randomized controlled trials; n = 22 [39%] in adult ICUs; n = 34 [61%] in neonatal ICU or PICU) demonstrated reduced anxiety (ratio of means = 0.92; 95% CI, 0.87-0.97) and depression (ratio of means = 0.83; 95% CI, 0.69-0.99), but not post-traumatic stress disorder (ratio of means = 0.91; 95% CI, 0.80-1.04) or distress (ratio of means = 1.01; 95% CI, 0.95-1.07) among informal caregivers randomized to mental health interventions compared with controls within 3 months post-ICU discharge. Increased humanity (ratio of means = 1.11; 95% CI, 1.07-1.15), transcendence (ratio of means = 1.11; 95% CI, 1.07-1.15), and caregiver burden (ratio of means = 1.08; 95% CI, 1.05-1.12) were observed. No significant effects of mental health interventions observed after 3 months postdischarge. CONCLUSIONS: Mental health interventions for caregivers of critically ill patients improved short-term anxiety, depression, humanity, and transcendence while increasing burden. Clinicians should consider short-term prescriptions of mental health interventions to informal caregivers of critically ill patients with capacity to manage interventions.
OBJECTIVES: Determine effect of mental health interventions on psychologic outcomes in informal caregivers of critically illpatients. DATA SOURCES: Searches conducted in MEDLINE, Embase, and other databases from inception to October 31, 2019. STUDY SELECTION: Interventions for informal caregivers of critically illpatients in adult ICU, PICU, or neonatal ICU. DATA EXTRACTION: Two independent, blinded reviewers screened citations and extracted data. Random-effects models with inverse variance weighting pooled outcome data when suitable. Psychologic outcomes categorized: 1) negative (anxiety, depression, post-traumatic stress disorder, distress, and burden) or 2) positive (courage, humanity, justice, transcendence, temperance, and wisdom and knowledge). Stratification according to intervention type and patient population was performed. DATA SYNTHESIS: Of 11,201 studies, 102 interventional trials were included (n = 12,676 informal caregivers). Interventions targeted caregiver experience (n = 58), role (n = 6), or support (n = 38). Meta-analysis (56 randomized controlled trials; n = 22 [39%] in adult ICUs; n = 34 [61%] in neonatal ICU or PICU) demonstrated reduced anxiety (ratio of means = 0.92; 95% CI, 0.87-0.97) and depression (ratio of means = 0.83; 95% CI, 0.69-0.99), but not post-traumatic stress disorder (ratio of means = 0.91; 95% CI, 0.80-1.04) or distress (ratio of means = 1.01; 95% CI, 0.95-1.07) among informal caregivers randomized to mental health interventions compared with controls within 3 months post-ICU discharge. Increased humanity (ratio of means = 1.11; 95% CI, 1.07-1.15), transcendence (ratio of means = 1.11; 95% CI, 1.07-1.15), and caregiver burden (ratio of means = 1.08; 95% CI, 1.05-1.12) were observed. No significant effects of mental health interventions observed after 3 months postdischarge. CONCLUSIONS: Mental health interventions for caregivers of critically illpatients improved short-term anxiety, depression, humanity, and transcendence while increasing burden. Clinicians should consider short-term prescriptions of mental health interventions to informal caregivers of critically illpatients with capacity to manage interventions.
Authors: Samiha Mohsen; Stephana J Moss; Filipe Lucini; Karla D Krewulak; Henry T Stelfox; Daniel J Niven; Khara M Sauro; Kirsten M Fiest Journal: Crit Care Med Date: 2022-08-26 Impact factor: 9.296
Authors: Brianna K Rosgen; Karla D Krewulak; Judy E Davidson; E Wesley Ely; Henry T Stelfox; Kirsten M Fiest Journal: BMC Psychiatry Date: 2021-04-09 Impact factor: 3.630
Authors: Blair Wendlandt; Agathe Ceppe; Bradley N Gaynes; Christopher E Cox; Laura C Hanson; Judith E Nelson; Shannon S Carson Journal: Crit Care Explor Date: 2022-03-01