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Use of a personal diary written on the ICU during critical illness
Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
2001 (engelsk)Inngår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 27, nr 2, s. 426-9Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: To explore the use of a diary as an aid in debriefing patients and relatives following critical illness. Design: Observation study. Setting: Intensive care unit of a 500-bed hospital. Patients and participants: Fifty-one critically ill patients and their relatives. Method: A daily account of the patient's progress was written in everyday language by nursing staff, photographs were added as necessary. The booklet was given to the patient or a relative at a follow-up appointment 2 weeks after discharge from the unit. A standard questionnaire was mailed 6 months later, responses were analyzed by an independent observer. Measurements and results: All diaries had been read by survivors (n=41) or relatives (n=10), 51% of the diaries had been read more than 10 times. Comments in the questionnaires were graded as very positive (39%), positive (28%) and neutral (33%). Conclusions: A detailed narrative of the patient's stay is a useful tool in the debriefing process following intensive care.

sted, utgiver, år, opplag, sider
SpringerLink , 2001. Vol. 27, nr 2, s. 426-9
HSV kategori
Identifikatorer
URN: urn:nbn:se:liu:diva-70479DOI: 10.1007/s001340000692PubMedID: 11396288OAI: oai:DiVA.org:liu-70479DiVA, id: diva2:439842
Tilgjengelig fra: 2011-09-09 Laget: 2011-09-09 Sist oppdatert: 2017-12-08bibliografisk kontrollert
Inngår i avhandling
1. The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives.: A descriptive and interventional study
Åpne denne publikasjonen i ny fane eller vindu >>The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives.: A descriptive and interventional study
2011 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Background: Patients on the ICU often spend a great deal of their time either unconscious or heavily sedated. When they return from the zone between life and death they are often in a state of confusion where dreams and delusions are intertwined with reality and it is not always easy to distinguish them apart. These experiences could lead to psychological problems and post-traumatic stress disorder (PTSD). Recovery may be improved by filling in the significant memory gaps and explaining what really happened during the “chaotic” time on the ICU. The provision of a diary describing the patients’ stay in ICU on a day to day basis and a follow-up meeting (together named the ICU-diary concept), may help the whole family to understand.

Aim: The principal aim of this thesis was to see if the ICU-diary concept was of help to patients and relatives in the recovery after critical illness. A further aim was to look for precipitants in the ICU of PTSD.

Material and Methods: ICU patients in a handful of European countries and their relatives have been studied. The studies have been single and multi-centred and we have used descriptive observational, randomised controlled and cohort study designs, including matched case-control designs. Quantitative methods have been used with questionnaires and structured interviews using established instruments (i.e Post-traumatic stress syndrome screening-14, Post-traumatic diagnostic scale, ICU memory tool, Short Form-36, Pearlin-Schooler Mastery Scale, Hopelessness scale) as the principal means of data collection.

Results: The ICU-diary concept was seen to be a positive and useful aid in helping patients and their relatives understand the events that took place during the time on the ICU. It also decreased the risk for PTSD among patients and relatives. Patients that were supported with the ICU-diary concept perceived a better health-related quality of life even 3 years after the ICU stay. We did not find any definite improvement by the ICU-diary concept in mastery and hope. Variations in how the patients were cared for in the ICU had a significant effect on the development of PTSD. The implementation of an ICU diary, for instance, was associated with a lower frequency of PTSD.

Conclusions: The ICU-diary concept was found helpful by patients and their relatives. It was associated with a reduction in new onset PTSD and improved health-related quality of life. The results are encouraging and suggest that an ICU diary may represent an important first step to help patients and relatives come to terms with their experiences during critical illness.ISBN 978-

sted, utgiver, år, opplag, sider
Linköping: Linköping University Electronic Press, 2011. s. 44
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1259
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-70485 (URN)978-91-7393-076-5 (ISBN)
Disputas
2011-09-30, Fornborgen, Vrinnevisjukhuset, Norrköping, 13:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2011-09-09 Laget: 2011-09-09 Sist oppdatert: 2012-06-20bibliografisk kontrollert

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