Aust Crit Care. 2026 Feb 4;39(2):101529. doi: 10.1016/j.aucc.2025.101529. Online ahead of print.
ABSTRACT
OBJECTIVES: The objective of this study was to evaluate the effectiveness of nurse-led interventions designed to prevent or mitigate the severity of post-intensive care syndrome (PICS) among adult intensive care unit (ICU) survivors.
REVIEW METHOD USED: A systematic review was conducted.
DATA SOURCES: A systematic search was conducted in five databases (EMBASE, CINAHL, PsycINFO, PubMed, and the Cochrane Library) from January 2012 to April 2024.
METHOD: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a systematic review. We included studies involving original experimental designs and nurse-led interventions aimed at addressing PICS outcomes in adult ICU survivors. The methodological quality of the studies was evaluated using revised Risk of Bias tool and Risk of Bias Assessment Tool for Nonrandomized Studies 2. Given the heterogeneity of the included studies, we conducted a synthesis without a meta-analysis.
RESULTS: Twenty-one studies (13 randomised controlled trials and 8 quasi-experimental studies) were included. Five types of nurse-led interventions were identified: clinical interventions (7 studies), patient education (3 studies), consultation and counselling (5 studies), follow-up programs (3 studies), and diary interventions (3 studies). Psychological outcomes were the most frequently assessed domain (17 studies), yet findings were inconsistent across interventions. Physical health was the least examined domain (2 studies), both reporting statistically significant effects. Cognitive function (4 studies) and quality of life (6 studies), however, showed no significant effects.
CONCLUSIONS: Nurse-led interventions demonstrated effects, particularly in psychological and physical domains, but showed limited effects on cognitive outcomes and quality of life. Due to methodological heterogeneity, definitive conclusions regarding overall effectiveness remain challenging. Despite these limitations, the findings underscore the central role of nurses in delivering and coordinating diverse interventions throughout the ICU survivorship trajectory. This review further highlights insufficient preventive strategies prior to ICU admission and the lack of comprehensive assessments across all PICS domains, supporting the need for a continuum of care approach in future research.
PMID:41643272 | DOI:10.1016/j.aucc.2025.101529
