Evidence map›Paper›PMID 34930440›Full record

ArticleCritical care (London, England)2021

A pilot study of trained ICU doulas providing early psychological support to critically ill patients.

Lioudmila V Karnatovskaia, Katalin Varga, Alexander S Niven, Phillip J Schulte, Midhat Mujic, Ognjen Gajic, Brent A Bauer, Matthew M Clark, Roberto P Benzo, Kemuel L Philbrick

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03736954 (Pilot Study of ICU Doulas Providing Psychological Support Based on Positive Suggestions to Mitigate Psychological and Cognitive Sequelae of Critical Illness), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03736954 nacompletednot on this map

Pilot Study of ICU Doulas Providing Psychological Support Based on Positive Suggestions to Mitigate Psychological and Cognitive Sequelae of Critical Illness

TypeinterventionalSponsorMayo ClinicRan2018 to 2021Enrolled42ConditionsIllness, Critical, Anxiety, Depression, Post Traumatic Stress DisorderArmspositive suggestion
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Lioudmila V KarnatovskaiaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Karnatovskaia.lioudmila@mayo.edu.ORCID 0000-0002-9689-3792
Katalin VargaAffective Psychology Department, Eötvös Loránd University, Budapest, Hungary.
Alexander S NivenDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Phillip J SchulteBiomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Midhat MujicAnesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN, USA.
Ognjen GajicDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Brent A BauerDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Matthew M ClarkDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Roberto P BenzoDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Kemuel L PhilbrickDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic · USMayo Clinic in Florida · USEötvös Loránd University · HU

Funding

Psychological support based on positive suggestions in acute respiratory failure patientsK23HL146741 · NHLBI · MAYO CLINIC ROCHESTER · PI KARNATOVSKAIA, LIOUDMILA · 2020 to 2024
$929k
Mechanistic Effects of Health Coaching to reduce COPD HospitalizationsK24HL138150 · NHLBI · MAYO CLINIC ROCHESTER · PI BENZO, ROBERTO PABLO · 2018 to 2022
$602k
NHLBI NIH HHS K23 HL146741NHLBI NIH HHS K24 HL138150NIH HHS K23HL146741-1
6 · The paper itself

Abstract

backgroundOver a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed.

methodsAdult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models.

resultsOf the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of < 2 days, transitioning to comfort care or not wanting to answer the study questionnaires. Forty-three patients who completed 2 or more sessions of the positive therapeutic suggestion intervention provided by two trained ICU doulas received it for a median of 4 days (IQR 3, 5), with each session lasting for a median of 20 min (IQR 14, 25). The intervention was delivered on 71% of days, meeting our pre-determined feasibility goal. Compared to historical controls (N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)-Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients.

conclusionsPositive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1 .

Indexed as

Critical IllnessDoulasAdultHumansIntensive Care UnitsPilot ProjectsProspective StudiesAnxietyCritically illDepressionDoulaPositive suggestionPsychological supportPTSDTherapeutic suggestion

Identifiers

PMID34930440
PMCPMC8691072
OpenAlexW4200003323

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.