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Could complementary health approaches improve the symptom experience and outcomes of critically ill adults? A systematic review of randomized controlled trials.
Complement Ther Med 2019; 47:102166CT

Abstract

OBJECTIVE

The purpose of this systematic review was to critically evaluate the safety and effectiveness of various complementary health approaches (CHAs) in treating symptoms experienced by critically ill adults.

METHODS

The review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Electronic databases (PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Education Resources Information Center, Medline, PsychInfo) were searched for studies published from 1997-2017. Randomized controlled trials (RCTs), in English with terms ICU/critical care, music, Reiki, therapeutic touch, healing touch, aromatherapy, essential oil, reflexology, chronotherapy, or light therapy were eligible for inclusion. Studies conducted outside the ICU, involving multiple CHAs, or enrolling pediatric patients were excluded. Data were extracted and assessed independently by two authors and reviewed by two additional authors. The Cochrane risk of bias tool was used to assess study quality.

RESULTS

Thirty-two RCTs were included involving 2,987 critically ill adults. 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). Half of all studies had a high risk of bias for randomization but had low or unclear biases for other categories. No study-related adverse events or safety-related concerns were reported. 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).

CONCLUSIONS

Evidence suggests CHAs may reduce the symptom burden of critically ill adults.

Authors+Show Affiliations

The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States. Electronic address: thrane.2@osu.edu.The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States.The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States.The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States.The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States.The Ohio State University, College of Nursing, Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, United States.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31780011

Citation

Thrane, Susan E., et al. "Could Complementary Health Approaches Improve the Symptom Experience and Outcomes of Critically Ill Adults? a Systematic Review of Randomized Controlled Trials." Complementary Therapies in Medicine, vol. 47, 2019, p. 102166.
Thrane SE, Hsieh K, Donahue P, et al. Could complementary health approaches improve the symptom experience and outcomes of critically ill adults? A systematic review of randomized controlled trials. Complement Ther Med. 2019;47:102166.
Thrane, S. E., Hsieh, K., Donahue, P., Tan, A., Exline, M. C., & Balas, M. C. (2019). Could complementary health approaches improve the symptom experience and outcomes of critically ill adults? A systematic review of randomized controlled trials. Complementary Therapies in Medicine, 47, p. 102166. doi:10.1016/j.ctim.2019.07.025.
Thrane SE, et al. Could Complementary Health Approaches Improve the Symptom Experience and Outcomes of Critically Ill Adults? a Systematic Review of Randomized Controlled Trials. Complement Ther Med. 2019;47:102166. PubMed PMID: 31780011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Could complementary health approaches improve the symptom experience and outcomes of critically ill adults? A systematic review of randomized controlled trials. AU - Thrane,Susan E, AU - Hsieh,Katie, AU - Donahue,Paige, AU - Tan,Alai, AU - Exline,Matthew C, AU - Balas,Michele C, Y1 - 2019/09/07/ PY - 2019/06/18/received PY - 2019/07/30/revised PY - 2019/07/31/accepted PY - 2019/11/30/entrez PY - 2019/11/30/pubmed PY - 2019/11/30/medline KW - Complementary health approaches KW - Critical care KW - Delirium KW - Intensive care KW - Pain KW - Sedation KW - Systematic review SP - 102166 EP - 102166 JF - Complementary therapies in medicine JO - Complement Ther Med VL - 47 N2 - OBJECTIVE: The purpose of this systematic review was to critically evaluate the safety and effectiveness of various complementary health approaches (CHAs) in treating symptoms experienced by critically ill adults. METHODS: The review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Electronic databases (PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Education Resources Information Center, Medline, PsychInfo) were searched for studies published from 1997-2017. Randomized controlled trials (RCTs), in English with terms ICU/critical care, music, Reiki, therapeutic touch, healing touch, aromatherapy, essential oil, reflexology, chronotherapy, or light therapy were eligible for inclusion. Studies conducted outside the ICU, involving multiple CHAs, or enrolling pediatric patients were excluded. Data were extracted and assessed independently by two authors and reviewed by two additional authors. The Cochrane risk of bias tool was used to assess study quality. RESULTS: Thirty-two RCTs were included involving 2,987 critically ill adults. 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). Half of all studies had a high risk of bias for randomization but had low or unclear biases for other categories. No study-related adverse events or safety-related concerns were reported. 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). CONCLUSIONS: Evidence suggests CHAs may reduce the symptom burden of critically ill adults. SN - 1873-6963 UR - https://www.unboundmedicine.com/medline/citation/31780011/Could_complementary_health_approaches_improve_the_symptom_experience_and_outcomes_of_critically_ill_adults_A_systematic_review_of_randomized_controlled_trials L2 - https://linkinghub.elsevier.com/retrieve/pii/S0965-2299(19)30871-4 DB - PRIME DP - Unbound Medicine ER -