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Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study
ICU, Whiston Hospital, Prescot, UK.
Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science. Linköping University, Faculty of Health Sciences.
ICU, Whiston Hospital, Prescot, UK.
2012 (English)In: American Journal of Critical Care, ISSN 1062-3264, E-ISSN 1937-710X, Vol. 21, no 3, 172-176 p.Article in journal (Refereed) Published
Abstract [en]

Background: Relatives of patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD).

Objectives: The primary aim of this pilot study was to test whether the provision of an ICU diary to the patient and their relatives reduced the level of PTSD-related symptoms in the close family members.

Methods: Observational study of close family members of Intensive care patients, with an Intensive Care Unit (ICU) stay of more than 72 hrs, recruited in two centres of a 12 centred randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of new onset PTSD on patients. The close family members of the patients were recruited to examine the additional effect of the provision of the patient diary on their PTSD-related symptoms.

Results 36 family members were recruited and 30 completed the study. Where the patient received their diary at 1 month the family members showed lower levels of PTSD-related symptoms (p=0.03) at the 3 month follow-up compared to the control relatives.

Conclusions: The provision of an ICU diary may be effective in aiding psychological recovery in families after critical illness.

Place, publisher, year, edition, pages
Aliso Viejo, CA, USA: American Association of Critical Care Nurses , 2012. Vol. 21, no 3, 172-176 p.
Keyword [en]
Families, critical illness, diaries, PTSD-related symptoms, memories, intervention, follow-up, rehabilitation
National Category
Anesthesiology and Intensive Care
URN: urn:nbn:se:liu:diva-70482DOI: 10.4037/ajcc2012569ISI: 000310641300011PubMedID: 22549573OAI: diva2:439852

The article originial title before publishing on line was Intensive Care diaries reduce PTSD-related symptom levels in relatives following critical illness: a pilot study.

Available from: 2011-09-09 Created: 2011-09-09 Last updated: 2015-10-12Bibliographically approved
In thesis
1. The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives.: A descriptive and interventional study
Open this publication in new window or tab >>The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives.: A descriptive and interventional study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
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-

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 44 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1259
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-70485 (URN)978-91-7393-076-5 (ISBN)
Public defence
2011-09-30, Fornborgen, Vrinnevisjukhuset, Norrköping, 13:00 (Swedish)
Available from: 2011-09-09 Created: 2011-09-09 Last updated: 2012-06-20Bibliographically approved

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