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Critical care medicine · Dec 2022
Randomized Controlled Trial Multicenter StudyImpact of a Nurse-Driven Patient Empowerment Intervention on the Reduction in Patients' Anxiety and Depression During ICU Discharge: A Randomized Clinical Trial.
- Cecilia Cuzco, Pedro Castro, Raquel Marín Pérez, Samuel Ruiz García, Ana I Núñez Delgado, Marta Romero García, M Antonia Martínez Momblan, Llucia Benito Aracil, Inmaculada Carmona Delgado, Montse Canalias Reverter, José M Nicolás, Gemma Martínez Estalella, and Pilar Delgado-Hito.
- Medical lntensive Care Unit, Hospital Clinic of Barcelona, Barcelona, Spain.
- Crit. Care Med. 2022 Dec 1; 50 (12): 175717671757-1767.
ObjectivesTo assess the impact of a nurse-driven patient empowerment intervention on anxiety and depression of patients during ICU discharge.DesignA prospective, multicenter, randomized clinical trial.SettingThree ICUs (1 medical, 1 medical and surgical, and 1 coronary) of three tertiary hospitals.PatientsAdults admitted to the ICU greater than 18 years old for greater than or equal to 48 hours with preserved consciousness, the ability to communicate and without delirium, who were randomized to receive the nurse-driven patient empowerment intervention (NEI) (intervention group [IG] or standard of care [control group (CG)]) before ICU discharge.InterventionThe NEI consisted of an individualized intervention with written information booklets, combined with verbal information, mainly about the ICU process and transition to the ward, aimed at empowering patients in the transition process from the ICU to the general ward.Measurements And ResultsPatients completed the Hospital Anxiety and Depression Scale before and after (up to 1 wk) ICU discharge. IG ( n = 91) and CG ( n = 87) patients had similar baseline characteristics. The NEI was associated with a significant reduction in anxiety and depression ( p < 0.001) and the presence of depression ( p = 0.006). Patients with comorbidities and those without family or friends had greater reductions in anxiety and depression after the NEI. After the intervention, women and persons with higher education levels had lower negative outcomes.ConclusionsWe found that a NEI before ICU discharge can decrease anxiety and depression in critically ill survivors. The long-term effect of this intervention should be assessed in future trials.Trial RegistrationNCT04527627 ( https://clinicaltrials.gov/ct2/show/NCT04527627 ).Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
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