Bridging Gaps in Holistic Rehabilitation After Critical Illness: A Systematic Review

In Plain Language

Holistic care in the Intensive Care Unit (ICU) addresses the full spectrum of patient needs-physical, emotional, psychological, social, spiritual, and environmental-to support recovery and improve long-term outcomes after critical illness. This systematic review aimed to synthesize evidence on the effectiveness of holistic care interventions across these six dimensions of wellness in adult ICU patients. A systematic search of PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines. The SPICE framework was used to define the scope (Setting: ICU; Perspective: patients; Intervention: holistic care; Comparison: standard care; Evaluation: multi-dimensional outcomes). Studies published in English between 1999 and 2024 were included. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools. Seven studies, comprising randomized controlled trials, observational, and mixed-methods designs, met the inclusion criteria. The interventions were diverse, encompassing corporeal rehabilitation, spiritual care toolkits, reflexology, early physical therapy, patient diaries, and family involvement. A narrative synthesis of these heterogeneous studies suggested potential benefits and high acceptability for various patient-centered outcomes. The limited but promising evidence indicates that holistic care interventions may contribute positively to ICU patient recovery. The findings underscore the need for more robust, high-quality research to conclusively determine their efficacy and support their integration into standard critical care practice.