A systematic review on the effect of telehealth communication with intensive care unit families on patient and family outcomes.

Background: During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood.

Objective: The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment.

Review Method Used: A systematic review of relevant studies was undertaken.

Data Sources: Databases included CINAHL, APA PsychINFO, MEDLINE, and Ovid Embase.

Review Methods: Databases were searched with a date restriction of June 1st, 2011, to June 1st, 2023. Two independent reviewers assessed each study using the Mixed Methods Appraisal Tool, version 2 of the Cochrane risk-of-bias tool for randomised controlled trials, and the Risk Of Bias In Nonrandomised Studies of Interventions tool for methodological quality and risk of bias. Of the 2292 articles screened, 10 studies met the inclusion criteria.

Results: Ten studies were included (n = 3861). Methodological quality was mostly poor, with one study evaluated as high on Mixed Methods Appraisal Tool quality criteria. Two themes were derived from the literature: (i) patient and family satisfaction; and (ii) patient and family psychological distress symptoms. Five studies reported patient and family satisfaction, with four studies finding statistically significant improvement following the communication intervention. However, only one of the five studies specifically evaluated the satisfaction with the communication intervention. Nine studies reported patient and family psychological distress symptoms, using 12 measurement tools. A variable effect of interventions was found within this theme.

Conclusions: This review identified important gaps in the research examining remote-only family communication interventions in intensive care. Inconsistent delivery of remote-only communication interventions, biased research methods, and variable outcome measurement tools impacted the reliability and validity of current evidence. Further research on remote-only communication interventions and the effect on families is recommended.