Engström Asa, Grip Kristin, Hamrén Mikaela
Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden.
Nurs Crit Care. 2009 Mar-Apr;14(2):61-7. doi: 10.1111/j.1478-5153.2008.00312.x.
The aim of this study was to describe peoples' experiences of a personal diary written when they were critically ill and receiving care in an intensive care unit (ICU).
In some ICUs, diaries are written by the ICU staff and close relatives of those who are critically ill and mechanically ventilated, but there is a lack of studies that focus on the experiences of the formerly critically ill of personal diaries written when in an ICU.
Qualitative personal interviews were conducted with nine people who were formerly critically ill. The interview texts were analysed using qualitative content analysis.
From the analysis of the data, one theme emerged - touching a tender wound, with four categories: being afraid and being deeply touched, appreciating close relatives' notes, a feeling of unreality and gaining coherence. The participants were deeply touched when they read the diary for the first time. Parts of it were experienced as unreal, as if they were reading about someone else. The diary provided necessary knowledge about what had happened during the time when the participants were critically ill and from which they had only fragmented or no memories at all. Even though it aroused strong feelings, reading the diary was experienced as an important support for a long time after their stay in the ICU. Experiencing that one was not fully aware of what had happened and then reading about oneself being critically ill and about one's close relatives' experiences was interpreted as touching a tender wound.
It is suggested that a diary may be a tool that can help formerly critically ill people to gain a sense of coherence concerning their critical illness experience, but reading it can be painful and demanding.
本研究旨在描述人们对在重症监护病房(ICU)接受重症治疗期间所写个人日记的体验。
在一些重症监护病房,日记由重症监护病房工作人员以及重症且接受机械通气患者的近亲撰写,但缺乏关注曾经重症患者对在重症监护病房时所写个人日记体验的研究。
对9名曾经重症的患者进行了定性个人访谈。访谈文本采用定性内容分析法进行分析。
通过数据分析得出一个主题——触碰伤痛之处,包含四个类别:感到恐惧与深受触动、感激近亲的记录、不真实感以及获得连贯感。参与者首次阅读日记时深受触动。其中部分内容感觉不真实,仿佛在阅读他人的经历。日记提供了关于参与者重症期间所发生事情的必要信息,而他们对此只有零碎的记忆或根本没有记忆。尽管阅读日记引发了强烈的情感,但在离开重症监护病房后的很长一段时间里,阅读日记都被视为一种重要的支持。经历自己并未完全意识到所发生的事情,然后读到自己重症以及近亲的经历,这被解读为触碰伤痛之处。
建议日记可能是一种有助于曾经重症患者对其重症经历获得连贯感的工具,但阅读日记可能会很痛苦且要求较高。