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

Background: 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. Objective: This systematic review aimed to synthesize evidence on the effectiveness of holistic care interventions across these six dimensions of wellness in adult ICU patients. Methods: 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. Results: 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. Conclusions: 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.