重症患者ICU日记干预的证据图谱OA

Objective:Intensive care unit(ICU)diaries refer to written or pictorial records created by healthcare professionals and family members of patients during ICU hospitalization to document important events occurring throughout the patient's treatment.ICU diaries are considered an effective intervention for improving patient outcomes and quality of life.However,existing studies have reported inconsistent findings regarding diary formats and delivery timing.This study aims to systematically describe and evaluate the evidence on ICU diary interventions through evidence mapping,thereby providing references for clinical practice and guideline development. Methods:Relevant Chinese and international databases were searched from inception to April 1,2026.Randomized controlled trials(RCTs)and systematic reviews/Meta-analyses investigating ICU diary interventions in critically ill patients were included.The risk of bias in RCTs was assessed using the Cochrane Handbook 5.1.0 risk-of-bias assessment tool,while the methodological quality of systematic reviews was evaluated using A Measurement Tool to Assess Systematic Reviews 2(AMSTAR-2).Data extraction and coding were conducted using Microsoft Excel 2019,and bubble plots were generated to comprehensively present the characteristics of the included studies. Results:A total of 12 RCTs and 9 systematic reviews/Meta-analyses were included.Regarding intervention effectiveness,10 RCTs and all 9 systematic reviews/Meta-analyses concluded that ICU diary interventions were"beneficial"or"possibly beneficial".Regarding delivery timing,2 approaches were identified in the RCTs,namely delivery during ICU hospitalization and after ICU discharge,whereas delivery timing varied across systematic reviews/Meta-analyses.Regarding diary format,5 recording approaches were identified in the RCTs,including nurse-written diaries,family-written diaries,jointly written diaries by physicians and nurses,jointly written diaries by physicians,nurses,and family members,and diaries written by research teams.Three recording approaches were identified in systematic reviews/Meta-analyses,including jointly written diaries by physicians,nurses,and family members;by physicians,nurses,family members,and research teams;and by physicians,nurses,family members,research teams,and other relevant personnel.Outcome indicators in both RCTs and systematic reviews/Meta-analyses covered psychosocial health,physical health,perceived health,and functional health. Conclusion:ICU diary interventions may have potential positive effects on improving outcomes in critically ill patients.Further exploration is needed regarding implementation and management strategies,including diary authorship,content development,delivery timing,and outcome evaluation.Future high-quality studies are warranted to strengthen the evidence base and establish standardized management protocols.