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Peer Support in Critical Care: A Systematic Review
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A5080 - Peer Support in Critical Care: A Systematic Review
Author Block: K. J. Haines1, S. Beesley2, R. O. Hopkins3, J. McPeake4, T. Quasim5, K. Ritchie6, T. J. Iwashyna7; 1Physiotherapy, Western Health, Melbourne, Australia, 2Division of Pulmonary Medicine, Salt Lake City, UT, United States, 3Intermountain Medical Center, Murray, UT, United States, 4University of Glasgow, Glasgow, United Kingdom, 5Glasgow Royal Infirmary, Glasgow, United Kingdom, 6Library Services, Western Health, Melbourne, Australia, 7Univ of Michigan, Ann Arbor, MI, United States.
Rationale: Peer support has potential to ameliorate the burden of Post Intensive Care Syndrome (PICS) through promoting resilience and enhanced recovery. The aim of this systematic review was to identify and evaluate the previously published outcomes of peer support interventions on patient and family outcomes following critical illness and synthesise key elements of model design and structure.
Methods: A systematic search of MEDLINE, CINAHL, PsychInfo and EMBASE was undertaken May 2017. Inclusion criteria included: randomized, quasi-experimental or observational studies of 1) patients (adult or paediatric) who had been admitted to the intensive care unit and/or their family members and 2) had participated in a peer support intervention. Case reports, reviews, editorials or descriptive commentary publications were excluded. Two reviewers independently screened citations for studies that investigated peer support interventions in critical care cohorts. Data on outcomes of peer support and key elements of each model were extracted into a standardised form. The Preferred Reporting Items for Systematic Reviews guidelines were followed. PROSPERO ID: CRD42017070174.
Results: 2932 studies were screened and eight studies met criteria for inclusion. These studies included a total of 192 family members and 92 patients including adults (with conditions: cardiac surgery, acute myocardial infarction, trauma), paediatrics and neonates. Peer support reduced psychological morbidity and improved social support and self-efficacy in two studies; in both of these cases, peer support was delivered via an individual peer-to-peer model. In the remaining studies it was difficult to determine the outcomes of peer support as the reporting and quality of studies was low. The most common peer support model of the eight studies was an in-person, facilitated group for families that occurred during the patients’ ICU admission.
Conclusions: The evidence base for peer support in critical care is limited and no firm recommendations could be made. In the small number of existing studies, peer support appeared to reduce psychological morbidity and increase social support. There is a need for well-designed and rigorously reported research into this complex intervention.
Author Block: K. J. Haines1, S. Beesley2, R. O. Hopkins3, J. McPeake4, T. Quasim5, K. Ritchie6, T. J. Iwashyna7; 1Physiotherapy, Western Health, Melbourne, Australia, 2Division of Pulmonary Medicine, Salt Lake City, UT, United States, 3Intermountain Medical Center, Murray, UT, United States, 4University of Glasgow, Glasgow, United Kingdom, 5Glasgow Royal Infirmary, Glasgow, United Kingdom, 6Library Services, Western Health, Melbourne, Australia, 7Univ of Michigan, Ann Arbor, MI, United States.
Rationale: Peer support has potential to ameliorate the burden of Post Intensive Care Syndrome (PICS) through promoting resilience and enhanced recovery. The aim of this systematic review was to identify and evaluate the previously published outcomes of peer support interventions on patient and family outcomes following critical illness and synthesise key elements of model design and structure.
Methods: A systematic search of MEDLINE, CINAHL, PsychInfo and EMBASE was undertaken May 2017. Inclusion criteria included: randomized, quasi-experimental or observational studies of 1) patients (adult or paediatric) who had been admitted to the intensive care unit and/or their family members and 2) had participated in a peer support intervention. Case reports, reviews, editorials or descriptive commentary publications were excluded. Two reviewers independently screened citations for studies that investigated peer support interventions in critical care cohorts. Data on outcomes of peer support and key elements of each model were extracted into a standardised form. The Preferred Reporting Items for Systematic Reviews guidelines were followed. PROSPERO ID: CRD42017070174.
Results: 2932 studies were screened and eight studies met criteria for inclusion. These studies included a total of 192 family members and 92 patients including adults (with conditions: cardiac surgery, acute myocardial infarction, trauma), paediatrics and neonates. Peer support reduced psychological morbidity and improved social support and self-efficacy in two studies; in both of these cases, peer support was delivered via an individual peer-to-peer model. In the remaining studies it was difficult to determine the outcomes of peer support as the reporting and quality of studies was low. The most common peer support model of the eight studies was an in-person, facilitated group for families that occurred during the patients’ ICU admission.
Conclusions: The evidence base for peer support in critical care is limited and no firm recommendations could be made. In the small number of existing studies, peer support appeared to reduce psychological morbidity and increase social support. There is a need for well-designed and rigorously reported research into this complex intervention.
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