Effectiveness of family-provider communication interventions on family's psychological health, communication quality, and health care utilization in the ICU: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE

This review aims to assess evidence regarding the effectiveness of family-provider communication interventions.

METHODS

We searched six databases (PubMed, PsycINFO, Web of Science, EMBASE, CINAHL and the Cochrane Library). Two researchers independently extracted data and assessed bias. Data were analyzed using Stata software and Review Manager.

RESULTS

Nineteen studies were included. Communication interventions had a moderate effect on family needs (SMD = -0.43, 95 % CI: -0.81 to -0.06, P = 0.025), small effects on 6-month psychological distress (Overall: SMD = -0.14, 95 % CI: -0.34 to -0.04, P = 0.04; Anxiety: SMD = -0.16, 95 % CI: -0.28 to -0.05, P = 0.004), and reduced symptom prevalence (Anxiety: RR = 0.78, 95 % CI: 0.65-0.94, P = 0.009; Depression: RR = 0.79, 95 % CI: 0.65-0.97, P = 0.022; PTSD: RR = 0.70, 95 % CI: 0.53-0.94, P = 0.015), with a small ICU stay reduction (SMD = -0.10, 95 % CI: -0.20 to -0.01, P = 0.036). Face-to-face (FTF) with print supplements had a moderate effect on family needs (SMD = -0.53, 95 % CI: -0.69 to -0.36, P < 0.001), small effects on 3-month anxiety (RR = 0.59, 95 % CI: 0.44 to 0.79, P < 0.001) and depression incidence (RR = 0.62, 95 % CI: 0.44 to 0.89, P = 0.009). Conversely, FTF with digital supplements yielded small effects on communication quality (SMD = 0.28, 95 % CI: 0.05-0.52, P = 0.01), 6-month psychological distress (Overall: SMD = -0.19, 95 % CI: -0.34 to -0.04, P = 0.01; Anxiety: SMD = -0.22, 95 % CI: -0.34 to -0.10, P < 0.001; Depression: SMD = -0.17, 95 % CI: -0.29 to -0.04, P = 0.007; PTSD: SMD = -0.18, 95 % CI: -0.34 to -0.02, P = 0.03).

CONCLUSION

Family-provider communication interventions effectivelyimprovefamily needs and communication quality,enhancelong-term psychological outcomes, andreduceICU stays. Print materials excelled in immediate information delivery andacute distress alleviation, while digital communication tools were superior for sustained communication and long-term distress management.Notably,despitenurses assumingmultifaceted communication roles, robust evidence for their intervention effectiveness remains lacking.

IMPLICATIONS FOR CLINICAL PRACTICE: ICU providersshould consider utilizingprint materials for immediate information delivery and digital tools forongoing psychological support. Future studies must validate nurses' communication roles and develop optimized strategies to enhance these interventionsto fully leveragenurses' professional expertise.