Ask an answerable question (PICO)：
Mr. Liang, a 55-year-old patient, was admitted to the Intensive Care Unit (ICU) following abdominal and orthopedic surgeries due to a car accident. After successfully being weaned off the ventilator, he was transferred to a general ward for continued treatment. The patient, facing significant changes in his physical health, found himself unable to work or maintain daily living function, which led to a profound sense of sadness and tearfulness. He also experienced difficulty sleeping every night and lacked motivation for postoperative rehabilitation, once sighing and expressing, "I might as well start life over." Some scholars had proposed that the ICU diary was a tool to provide patients with emotional support.This raises the PICO question of whether reviewing ICU diaries can reduce the incidence of depression when they transferes to the general ward.
The Method and Analysis of Literature Review：
This article set up PICO keywords. MeSH terms or Emtree were used. A multi-database search (PubMed, Embase, The Cochrane Library, and the CEPS database) was conducted, set the key word「intensive care unit survivor」、「diary」、「depression」, limited to articles published within the last five years, including meta-analyses, systematic reviews, and randomized controlled trials. A total of 15 articles were retrieved, and after eliminating duplicates and articles which didn’t meet our PICO. Finally the auther choosed one systematic review and meta-analyses which included more trials and the lastest paper (Huang et al., 2024). The methodological quality of the included articles was assessed using the CASP checklist.
Critical Appraisal：
The CASP tool was used to evaluate the quality of the literature, and the Oxford CEBM evidence level (2011 version) was used to classify the the article that met the PICO topic. Huang et al. (2024) conducted a systematic review and meta-analysis of randomized controlled trials, which was strictly evaluated as Level 1(strength A). The evidence classification was evaluated as Level 1(strength A), using the Oxford CEBM evidence level (2011 version).
Results, Conclusions and Recommendations：
Huang et al. (2024) reported the psychological effects of ICU diary review on patients discharged from the ICU and their families. The study included 11 RCTs (1,682 participants). The experimental group, which recieved the ICU diary review, demonstrated a lower risk of developing depressive symptoms compared to the control group, which received routine care (OR: 0.62, 95% CI: 0.39-0.97, p=0.04).Based on the literature review, the use of ICU diaries for retrospective review by critically ill patients can reduce the incidence of depression after they transferred out of the ICU. Through the retrospective review of ICU diaries, patients can correctly recall their ICU stay and understand their ability to overcome the illness and transfer to a general ward, thus preventing the incidence of depression symptom.
吳俊賢 蔡佩臻 吳昭燕*
