Could Complementary Health Approaches Improve the Symptom Experience and Outcomes of Critically Ill Adults? A Systematic Review of Randomized Controlled Trials
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Date
2019-05
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The Ohio State University
Abstract
Sedative, analgesic, and antipsychotic medications are frequently administered in the intensive care unit (ICU) to treat a variety of symptoms. Evidence suggests these medications carry the risk of long-term physical, cognitive, and psychologic impairment. Thus, the purpose of this systematic review was to critically evaluate the effectiveness of various complementary health approaches (CHAs) in treating symptoms experienced by critically ill adults. We searched PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medline, and PsychInfo for studies published from 1997 to 2017. All randomized controlled trials (RCTs), in English with terms ICU/critical care, music, Reiki, therapeutic touch, healing touch, aromatherapy, essential oil, chronotherapy, or light therapy were eligible for inclusion. Studies conducted outside the ICU, involving multiple CHAs, or enrolling neonatal or pediatric patients were excluded. From 477 articles identified, 32 RCTs were included. The CHAs evaluated included music (n=19), nature based sounds (NBSs) (n=4), aromatherapy (n=3), light therapy (n=2), massage (n=2), and reflexology (n=2). No adverse events or safety related concerns were reported in the eligible studies. There were statistically significant improvements in pain (music, NBSs), anxiety (music, NBSs, aromatherapy, massage, reflexology), agitation (NBSs, reflexology), sleep (music, aromatherapy, reflexology), level of arousal (music, massage), and duration of mechanical ventilation (music, reflexology). Evidence suggests CHAs may reduce symptom burden in critically ill adults and those highlighted here are all within nursing scope of practice and easily implemented.
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1st place in Health Communication and Promotion, Denman Undergraduate Research Forum
Keywords
intensive care, critical care, complementary health approaches, systematic review, pain, anxiety