Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses

Zheng, Yafang; Zhang, Lijuan; Ma, Shihong; Wu, Bian; Chen, Peipei; Xu, Yan; Tan, Wenting; Li, Hanzhan; Wu, Qiaomei; Zheng, Jingxia

doi:10.1186/s13643-023-02372-5

Systematic Reviews

Table 1 Psychological outcomes and evidence class reported in included meta-analyses

From: Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses

Author	Year	Exposure	Exposure contrast	Study design	Population	Outcome	Studies, n	Participants, n	Type of effect size metric	Effect size (95% CI)	95% CI prediction intervals	P	I2	Egger’s P	Small-study effect	Excess significance bias		Evidence class¹
Author	Year	Exposure	Exposure contrast	Study design	Population	Outcome	Studies, n	Participants, n	Type of effect size metric	Effect size (95% CI)	95% CI prediction intervals	P	I2	Egger’s P	Small-study effect	O/E	P	Evidence class¹
Gazzato A	2022	ICU diary intervention	Without diaries	RCTs, cohort, case–control studies	Adults	PTSD	6	854	RR	0.82 (0.63, 1.07)	(0.54, 1.26)	0.147	0	0.009	yes	0/0.37	-	NS
						Anxiety	4	456	RR	0.64 (0.29, 1.40)	(0.03, 15.97)	0.264	66.86	0.399	-	1/0.20	0.187	NS
						Depression	4	456	RR	0.71 (0.49, 1.02)	(0.31, 1.59)	0.066	0	0.300	-	0/0.37	-	NS
Yue W	2021	Music therapy	Standard care	RCTs	Preterm infants and their mothers	Behavioral state	5	437	SMD	− 0.35 (− 1.08, 0.39)	(− 3.15, 2.46)	0.357	92.25	0.059	-	3/1.17	0.087	NS
						Stress level	2	90	SMD	− 17.91 (− 22.02, − 13.80)	-	< 0.001	0	-	-	1/2.00	-	Weak
						Maternal anxiety	2	276	SMD	− 2.08 (− 2.37, − 1.79)	-	< 0.001	0	-	-	2/2.00	1	Weak
Fuke R	2018	Early rehabilitation	No early rehabilitation or standard care	RCTs	Adult patients with critical illness	Hospital Anxiety and Depression Scale (HAS/HADS) score	2	92	OR	0.79 (0.29, 2.14)	-	0.640	-	-	-	0/0.40	-	NS
						QOL scores	2	63	SMD	0.11 (− 0.86, 1.09)	-	0.819	72.21	-	-	0/0.20	-	NS
						SF-36 PF	2	191	SMD	0.78 (0.01, 1.56)	-	0.049	0	-	-	1/0.23	-	Weak
Rosa RG	2019	Post-ICU follow-up	Usual care	RCTs or non-RCTs	Adults	Symptoms of depression	4	147	SMD	− 2.20 (− 4.51, 0.11)	-	0.062	0	-	-	0/0.94	-	NS
						Anxiety symptoms	4	147	SMD	− 1.90 (− 4.44, 0.64)	-	0.143	0	-	-	0/1.00	-	NS
						PTSD short term 0–3 months	4	574	SMD	− 0.45 (− 0.83, − 0.08)	-	0.671	0	-	-	1/0.26	0.258	Weak
						PTSD medium term 3–6 months	4	594	SMD	− 0.30 (− 0.57, − 0.03)	-	0.029	0	-	-	0.23/1.00	0.225	Weak
						PTSD long term > 6 months	3	510	SMD	− 0.16 (− 0.53, 0.21)	-	0.391	62.18	-	-	1/0.42	0.377	NS
						Quality of life (short term 0–3 months)	4	293	SMD	0.65 (0.14, 1.16)	-	0.012	0	-	-	1/0.29	0.289	Weak
						Quality of life (medium term 3–6 months)	2	207	SMD	0.14 (− 0.13, 0.42)	-	0.308	0	-	-	0/0.11	-	NS
Ng SX	2022	Preoperative education	Usual care	RCTs	Adults	Preoperative anxiety	6	657	SMD	− 0.90 (− 1.73, − 0.07)	(− 3.82, 2.02)	0.033	94.75	0.507	-	2/0.53	0.093	Weak
						Postoperative anxiety	6	623	SMD	− 0.49 (− 0.71, − 0.26)	(− 1.08, 0.11)	< 0.001	43.70	0.108	-	5/0.73	< 0.001	Weak
						Depression	3	397	SMD	− 0.21 (− 0.41, − 0.02)	(− 1.50, 1.07)	0.033	0	0.554	-	1/0.32	0.287	Weak
Erbay Dalli Ö	2022	Music interventions	Standard care or noise cancellation	RCTs	Adults	Anxiety	9	638	SMD	− 1.81 (− 3.11, − 0.50)	(− 6.91, 3.30)	0.007	97.48	0.012		9/6.04	0.126	Weak
Brooke J	2012	Information interventions	Standard care	RCTs	Patients and family members	Transfer anxiety	5	629	OR	0.32 (0.09, 1.17)	(0.00, 117.16)	0.085	87.22	0.577	-	2/0.22	0.017	NS
DeForge CE	2022	Communication and psychological support interventions	Usual care	RCTs	Adults	Anxiety 3 months	5	1561	SEM	− 0.47 (− 1.19, 0.25)	(− 2.62, 1.67)	0.199	51.75	0.922	-	2/3.86	-	NS
						Anxiety 6 months	4	1939	SEM	− 0.70 (− 1.19, − 0.22)	(− 2.19, 0.78)	0.004	23.79	0.876	-	1/3.94	-	Weak
						Depression 3 months	5	1552	SEM	− 0.68 (− 1.14, − 0.22)	(− 1.43, 0.07)	0.004	0	0.667	-	1/4.36	-	Weak
						Depression 6 months	5	2127	SEM	− 0.25 (− 1.15, 0.64)	(− 3.32, 2.81)	0.576	76.95	0.906	-	3/0.43	0.006	NS
						Post-traumatic stress 3 months	6	1659	SEM	− 0.25 (− 0.49, − 0.01)	(− 1.03, 0.54)	0.040	79.47	0.716	-	3/2.03	0.413	Weak
						Post-traumatic stress 6 months	5	2126	SEM	− 0.08 (− 0.27, 0.12)	(− 0.76, 0.60)	0.433	77.26	0.979	-	1/0.30	0.262	NS
Bibas L	2019	Surrogate Decision-making Interventions	standard care	RCTs	Adults	Anxiety	5	1365	SMD	− 0.10 (− 0.28, 0.08)	(− 0.68, 0.47)	0.265	69.08	0.727	-	1/0.26	0.235	NS
						Depression	5	1365	SMD	− 0.10 (− 0.28, 0.08)	(− 0.68, 0.47)	0.265	69.08	0.727	-	1/0.26	0.235	NS
						Posttraumatic stress disorder (PTSD)	4	1337	SMD	− 0.04 (− 0.20, 0.12)	(− 0.76, 0.68)	0.633	77.00	0.898	-	2/0.20	0.014	NS

¹Evidence class criteria—class I (convincing): statistical significance at P < 10⁻⁶, > 1000 cases (or > 20,000 participants for continuous outcomes), the largest component study reported a significant effect (P < 0.05); the 95% prediction interval excluded the null, no large heterogeneity (I² < 50%), no evidence of small-study effects (P > 0.10) and excess significance bias (P > 0.10); class II (highly suggestive): significance at P < 10⁻⁶, > 1000 cases (or > 20,000 participants for continuous outcomes), the largest component study reported a significant effect (P < 0.05); class III (suggestive): statistical significance at P < 10⁻³, > 1000 cases (or > 20,000 participants for continuous outcomes); and class IV (weak): the remaining significant associations at P < 0.05

Back to article page

ISSN: 2046-4053

Contact us

Submission enquiries: Access here and click Contact Us
General enquiries: info@biomedcentral.com