Family-centered interventions in ICU significantly improve mental health and clinical outcomes for patients: Study

A recent study found that family-centered interventions in the ICU can lead to significant improvements in both mental health and clinical outcomes for patients, with no negative impacts observed. The study results published in the Journal of Critical Care highlighted the importance of family engagement as a valuable part in critical care patients.

Understanding the impact of family engagement in the intensive care unit (ICU) on patient outcomes is critical for improving care. Family members play a vital role in providing physical and emotional support and also are the major decision makers. There is a lack of this part of care in many healthcare facilities. Hence, researchers conducted a study to understand the family-centered interventions with patient-related outcomes in the adult ICU.

A systematic review of the literature was carried out to understand the randomized controlled trials (RCTs) that examined family-centered interventions with patient-related outcomes in adult ICU settings by using databases like MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library. The data was collected from their inception until July 3, 2023. The relevant studies were selected based on the inclusion of RCTs conducted in adult critical care settings that focused on family-centered interventions. These interventions were required to have patient-related outcomes, such as those reported by patients themselves, or outcomes related to physiological and clinical factors. The extracted data included key information such as the author, publication year, setting, number of participants, type of intervention, specific intervention details, and the patient-related outcomes observed.

Findings: 

• A total of 28 RCTs were included in the review, comprising a total of 12,174 participants.
• Among the diversified interventions, the most common categories were interventions related to care provision and meeting the needs of patients and families (10 studies), followed by family presence in the ICU (7 studies).
• Other interventions included communication enhancements, family involvement in care decisions, and psychosocial support.
• Of the 28 RCTs reviewed, 16 (57%) reported at least one positive patient-related outcome resulting from the intervention.
• Importantly, no studies showed any negative effects or worse patient outcomes as a result of family-centered interventions.
• Positive outcomes reported in the studies ranged from improvements in patient-reported measures to clinical and physiological benefits.
• Patient-reported outcomes included significant reductions in anxiety, depression, post-traumatic stress symptoms, and improvements in satisfaction with care and health-related quality of life.
• Additionally, several studies reported favorable effects on physiological and clinical outcomes.
• These included reductions in the duration of mechanical ventilation, fewer adverse events, improved analgesia management, shorter ICU length of stay, reductions in delirium, and a faster time to the withdrawal of life-sustaining treatments in patients where this was appropriate.
• These findings suggest that involving families in care can lead to better patient experiences and contribute to improved physical health outcomes in critically ill patients.

The study concluded that positive patient related outcomes were seen due to family-centered interventions in adult ICU settings. The improvements observed spanned from mental health, patient satisfaction, physiological indices to key clinical metrics. The study also found that family involvement in the ICU can be beneficial for patient well-being without increasing the risk of adverse effects thus underscoring the potential of family-centered interventions in the care of critically ill patients with not only emotional and psychological support but also contributing to better overall clinical outcomes.

Further reading: Duong J, Wang G, Lean G, Slobod D, Goldfarb M. Family-centered interventions and patient outcomes in the adult intensive care unit: A systematic review of randomized controlled trials. J Crit Care. 2024;83:154829. doi:10.1016/j.jcrc.2024.154829