Nursing Intervention to Support Psychological Recovery Among Intensive Care Patients and Their Families: A Systematic Review with Narrative Synthesis.

BACKGROUND

Psychological distress is highly prevalent among intensive care unit (ICU) patients and their families, often persisting long after discharge and contributing to post-intensive care syndrome (PICS). Although nursing interventions play a critical role in addressing these challenges, existing evidence remains fragmented across different intervention approaches.

OBJECTIVE

This systematic review aimed to identify, categorize, and evaluate the effectiveness of nursing interventions in supporting psychological recovery among ICU patients and their families.

METHODS

A systematic review was conducted following PRISMA guidelines. Five electronic databases, including PubMed, Scopus, EBSCOhost, SpringerLink, and Taylor & Francis, were searched on 5 March 2026. Only randomized controlled trials (RCTs) were eligible for inclusion, as this design provides the highest level of evidence for evaluating intervention effectiveness and minimizes confounding bias. Eligible studies involved adult ICU patients and/or their family members receiving nursing-led or nursing-involved interventions targeting psychological outcomes. Data were synthesized narratively due to substantial clinical and methodological heterogeneity across interventions, populations, and outcome measures.

RESULTS

A total of 18 RCTs were included. Interventions were categorized into four domains: psychosocial, rehabilitation and follow-up, technology-based, and family-based interventions. Psychosocial interventions demonstrated effectiveness in reducing anxiety, although results for depression and PTSD were inconsistent. Rehabilitation and follow-up interventions improved physical and functional outcomes but showed limited effects on psychological recovery. Technology-based interventions, particularly virtual reality, showed promising but variable results depending on their integration with therapeutic support. Family-based interventions appeared promising in improving psychological outcomes across patients and caregivers, though this finding is based on a limited number of studies and warrants further investigation. A significant gap was identified in the pre-ICU phase, with very limited evidence on preventive interventions.

CONCLUSION

Nursing interventions have the potential to support psychological recovery in ICU populations, particularly when delivered as multicomponent, family-centered, and continuous care. However, current evidence remains limited by methodological heterogeneity, risk of bias, inconsistent outcomes, and the predominance of studies from high-income settings, which limits generalizability.