Evidence mapPaperPMID 41740153Full record

ReviewJournal of medical Internet research2026

The Effects of Digital Health Interventions for Family Members in Intensive Care Units: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Chuchu Zhang, Weijing Sui, Weilin Jiang, Yibing Shen, Zhenzhen Huang, Ran Yan, Jia Yi, Jiayu Zhang, Chaoyi Zhang, Yiyu Zhuang and 1 more

Abstract readReview
In one paragraph

Review in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  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

11 authors.

Chuchu ZhangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0005-5277-1047
Weijing SuiDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0000-0001-8407-3765
Weilin JiangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0000-3357-165X
Yibing ShenDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0004-9392-3011
Zhenzhen HuangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0007-2593-3228
Ran YanDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0006-6939-0969
Jia YiDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0002-8918-9622
Jiayu ZhangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0001-6143-0296
Chaoyi ZhangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0008-4358-6298
Yiyu ZhuangDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0000-0003-1171-4351
Xiaoyan GongDepartment Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0009-0003-0570-3864

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFamily members of intensive care units (ICUs) often experience psychological difficulties like anxiety and depression, which affect family functioning and their ability to support patient recovery. Digital health interventions (DHIs) offer accessible and timely support; yet, evidence regarding their effectiveness for ICU families demonstrates inconsistent.

objectiveThis systematic review and meta-analysis aimed to explore the impact of DHIs on psychological outcomes, quality of life (QoL), and quality of communication (QOC) among ICU family members.

methodsA total of 9 databases (CNKI [China Knowledge Resource Integrated Database], Wanfang, VIP [Weipu Database], SinoMed, Cochrane Library, PubMed, Embase, CINAHL, and Web of Science) were searched for randomized controlled trials (RCTs) published up to October 11, 2025. Eligible studies evaluated DHIs targeting adult ICU patients' family members and reported psychological outcomes, QoL, or QOC; interventions used solely for monitoring or tracking were excluded. Furthermore, 2 reviewers independently screened studies, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias Tool. Random-effects meta-analyses were performed using the Hartung-Knapp-Sidik-Jonkman method. Prediction intervals (PIs) were calculated to reflect between-study heterogeneity. Subgroup analyses were performed by patients' primary diagnosis, relationship with patients, and type of digital health technology. Evidence quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

resultsIn total, 17 RCTs involving 1864 participants were included. Interrater agreement was high across study selection and assessment processes (κ=0.55-1.00). Most studies were judged to have some concerns about the risk of bias. Meta-analyses showed no statistically significant pooled effects of DHIs on anxiety (standardized mean difference [SMD] -0.34, 95% CI -0.68 to 0.00; 95% PI -1.46 to 0.79; P=.05), depression (SMD -0.26, 95% CI -0.52 to 0.01; 95% PI -1.11 to 0.60; P=.06), posttraumatic stress disorder (SMD -0.21, 95% CI -0.49 to 0.06; 95% PI -1.03 to 0.60; P=.11), QoL (SMD 0.09, 95% CI -0.10 to 0.28; 95% PI -0.41 to 0.60; P=.36), or QOC (SMD 0.14, 95% CI -0.03 to 0.31; 95% PI -0.26 to 0.55; P=.10). Wide PIs indicated substantial variability in intervention effects across settings. The certainty of evidence ranged from very low to moderate.

conclusionsThis review emphasizes significant uncertainty in estimated effects and provides the first thorough synthesis of RCT evidence on DHIs for ICU family members. The inherently high heterogeneity and low certainty of the underlying evidence limit the conclusions of this review, despite its methodological rigor and use of PIs. Compared with previous reviews, this review concentrates on the ICU family members and includes more recent research. Future studies should focus on high-risk subgroups, use mixed methods designs, and develop theory-informed, personalized, and interactive DHIs. DHIs may enable proactive, customized communication techniques for families of ICU patients, even when there are few formal clinical recommendations.

trial registrationPROSPERO CRD420251044704; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251044704.

Indexed as

digital health interventionsfamily membersintensive care unitsmeta-analysispsychologyrandomized controlled trialssystematic review

Identifiers

PMID41740153
PMCPMC12980072

What Socratic holds

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LicenceCC BY
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Registered trials

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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 Socratic graph.