***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: While an admission to the Intensive Care Unit ( ICU ) is stressful , the impending transfer from ICU to the ward can also result in anxiety for patients and their families . The aim of this study was to identify the effect of an ICU liaison nurse on anxiety experienced by patients and their families just prior to transfer to the ward . This block intervention study used a repeated before and after design , with the first control and intervention periods of 4 months , a wash-out period of 1 month , and then a second control and intervention period of 4 months duration . That is , after 4 months of control and another 4 months of intervention , the liaison nurse services were withdrawn and no data collection occurred for a month ( wash-out ) then a second set of 4-month blocks of control and intervention were undertaken . A st and ard transfer protocol was followed during the control periods whereas during the intervention periods , the liaison nurse prepared patients and their families for transfer to the ward . The State Trait Anxiety Form Y ( State ) was used to measure anxiety just prior to physical relocation to the ward . A total of 115 patients ( 62 control , 53 intervention ) and 100 families ( 52 control , 48 intervention ) were enrolled in the study . There was no difference in anxiety scores between the control and intervention groups in either patients or family groups . This study did not demonstrate a statistically significant beneficial effect of the liaison nurse in terms of pre-transfer anxiety , however it highlights several method ological issues that must be considered for future research including sample size estimates , timing and measurement of transfer anxiety and finally the intervention itself Background Family members of patients in intensive care units ( ICUs ) are at risk for mental health morbidity both during and after a patient ’s ICU stay . Objectives To determine prevalences of and factors associated with anxiety , depression , posttraumatic stress and complicated grief in family members of ICU patients . Design Prospect i ve , longitudinal cohort study . Participants Fifty family members of patients in ICUs at a large university hospital participated . Measurements We used the Control Preferences Scale to determine participants ’ role preferences for  surrogate decision-making .  We used the  Hospital Anxiety and Depression Scale , Impact of Event Scale , and Inventory of Complicated Grief  to  measure anxiety and depression ( at enrollment , 1 month , 6 months ) , posttraumatic stress ( 6 months ) , and complicated grief ( 6 months ) . Results We interviewed all 50 participants at enrollment , 39 ( 78 % ) at 1 month , and 34 ( 68 % ) at 6 months . At the three time points , anxiety was present in 42 % ( 95 % CI , 29–56 % ) , 21 % ( 95 % CI , 10–35 % ) , and 15 % ( 95 % CI , 6–29 % ) of participants . Depression was present in 16 % ( 95 % CI , 8–28 % ) , 8 % ( 95 % CI , 2–19 % ) , and 6 % ( 95 % CI , 1–18 % ) . At 6 months , 35 % ( 95 % CI , 21–52 % ) of participants had posttraumatic stress . Of the 38 % who were bereaved , 46 % ( 95 % CI , 22–71 % ) had complicated grief . Posttraumatic stress was not more common in bereaved than nonbereaved participants , and neither posttraumatic stress nor complicated grief was associated with decision-making role preference or with anxiety or depression during the patient ’s ICU stay . Conclusions Symptoms of anxiety and depression diminished over time , but both bereaved and nonbereaved participants had high rates of posttraumatic stress and complicated grief . Family members should be assessed for posttraumatic stress and complicated grief Objective Anxiety and depression may have a major impact on a person ’s ability to make decisions . Characterization of symptoms that reflect anxiety and depression in family members visiting intensive care patients should be of major relevance to the ethics of involving family members in decision-making , particularly about end-of-life issues . Design Prospect i ve multicenter study . Setting Forty-three French intensive care units ( 37 adult and six pediatric ) ; each unit included 15 patients admitted for longer than 2 days . Patients Six hundred thirty-seven patients and 920 family members . Interventions Intensive care unit characteristics and data on the patient and family members were collected . Family members completed the  Hospital Anxiety and Depression Scale  to allow evaluation of the prevalence and potential factors associated with symptoms of anxiety and depression . Measurements and Main Results Of 920  Hospital Anxiety and Depression Scale  question naires that were completed by family members , all items were completed in 836 question naires , which formed the basis for this study . The prevalence of symptoms of anxiety and depression in family members was 69.1 % and 35.4 % , respectively . Symptoms of anxiety or depression were present in 72.7 % of family members and 84 % of spouses . Factors associated with symptoms of anxiety in a multivariate model included patient-related factors ( absence of chronic disease ) , family-related factors ( spouse , female gender , desire for professional psychological help , help being received by general practitioner ) , and caregiver-related factors ( absence of regular physician and nurse meetings , absence of a room used only for meetings with family members ) . The multivariate model also identified three groups of factors associated with symptoms of depression : patient-related ( age ) , family-related ( spouse , female gender , not of French descent ) , and caregiver-related ( no waiting room , perceived contradictions in the information provided by caregivers ) . Conclusions More than two-thirds of family members visiting patients in the intensive care unit suffer from symptoms of anxiety or depression . Involvement of anxious or depressed family members in end-of-life decisions should be carefully discussed INTRODUCTION This intervention study examines anxiety and uncertainty in illness in families transferring from intensive care to a general ward . METHODS The pre-test , post-test design purposively allocated family members to a  control ( n = 80 ) and intervention group ( n = 82 ) . The intervention group experienced a structured individualised transfer method whereas the control group received existing ad hoc transfer methods . Families were surveyed before and after transfer . RESULTS Families ' uncertainty was significantly related to their state anxiety ( P < 0.000 ) , the relationship to the patient ( P = 0.022 ) , and the unexpected nature of patients ' admission ( P < 0.000 ) . Anxiety increased significantly with reduced social support ( P = 0.002 ) . Following transfer , anxiety reduced significantly for both groups whereas uncertainty reduced significantly for the intervention group ( P = 0.03 ) . CONCLUSION Families at the time of transfer experience uncertainty and anxiety , which are significantly related in this study . The intervention significantly reduced uncertainty scores . When the family member was a parent , when admissions were unexpected , and those with fewer social supports represent potential ' at risk ' groups whose adaptation to transfer may limit their coping ability . The structured individualised method of transfer is recommended with further research of ICU families to further examine the dimension of uncertainty and how it affects patient outcomes 
    Output:
    
The results of this meta- analysis show that training will decline the anxiety level of a family with patients hospitalized in the intensive care unit , although the impact is not considerable