META-ANALYSIS OF THE EFFECTS OF VARIOUS ENHANCED NURSING INTERVENTIONS ON DELIRIUM IN ICU INPATIENTS: IMPLICATIONS FOR ATHLETIC HEALTH MANAGEMENT

Abstract

Objective: To compare the effectiveness of various non-pharmacological interventions in preventing delirium among ICU patients and identify the optimal strategies. Methods: This meta-analysis assessed hazard ratios (RRs) for delirium incidence and in-hospital mortality, and calculated mean differences (MDs) in delirium duration and ICU length of stay. Interventions were ranked based on clinical outcomes, using data from randomized controlled trials. Bayesian network meta-analysis was employed to evaluate the efficacy of different intensive care interventions, with a focus on seven types: physical environment improvement (PEI), sedative reduction (SR), family participation (FP), exercise programs (EP), cerebral hemodynamics improvement (CHI), multi-component interventions (MLT), and usual care (UC). Results: Twenty-one studies were included, covering diverse intervention strategies. Family participation (FP) and multi-component interventions (MLT) emerged as the most effective, significantly reducing delirium incidence compared to usual care. While the impact on delirium duration and ICU stay was generally inconclusive across interventions, MLT showed the highest efficacy in potentially reducing ICU length of stay. Notably, exercise programs (EP) significantly decreased in-hospital mortality, indicating a promising area for further research. Conclusion: Multi-component strategies, which integrate several simultaneous interventions, appear to be the most effective in preventing delirium and shortening ICU stays for patients. Family involvement also plays a crucial role, underscoring the need for patient-centered approaches in intensive care settings.