Department of Intensive Care Medicine, Malmö University Hospital, 205 02 Malmö, Sweden.
Nurs Crit Care. 2010 Jan-Feb;15(1):26-33. doi: 10.1111/j.1478-5153.2009.00364.x.
To describe and compare the extent and application of patients' diaries in Sweden.
Since 1991, patient diaries have been used in intensive care unit (ICU) follow-up in Sweden. There is paucity of relevant data evaluating the effect of this tool and also on what premises patients are enrolled. Likewise, data are sparse on the diaries' design, content structure and the use of photographs.
Descriptive explorative design by a semi-structured telephone interview.
The interview results were analysed with descriptive statistics and differences between the ICU levels were explored by chi(2) analysis. Qualitative manifest content analysis was performed to explore the purpose of diary writing.
Of all ICUs (n = 85), 99% responded and 75% used diaries. The source of inspiration was collegial rather than from scientific data. The main reason for keeping a diary was to help the patient to recapitulate the ICU stay. Discrepancies between the different levels of ICUs were detected in patient selection, dedicated staff for follow-up and the use of photographs. Comparison between the chi(2) analysis and the content analysis outcome displayed incongruence between the set unit-goals and the activities for achievement but did not explain the procedural differences detected.
The uses of diaries in post ICU follow up were found to be common in Sweden. A majority used defined goals and content structure. However, there were differences in practice and patient recruitment among the levels of ICUs. These discrepancies seemed not to be based on evidence-based data nor on ongoing research or evaluation but merely on professional judgement. As ICU follow-up is resource intense and time consuming, it is paramount that solid criteria for patient selection and guidelines for the structure and use of diaries in post-ICU follow-up are defined.
描述和比较瑞典患者日记的使用范围和应用情况。
自 1991 年以来，瑞典的重症监护病房（ICU）随访中已经开始使用患者日记。但是，目前缺乏评估该工具效果的相关数据，也缺乏关于入组患者的前提条件的数据。同样，关于日记的设计、内容结构和照片使用的数据也很少。
通过半结构化电话访谈进行描述性探索性设计。
使用描述性统计方法对访谈结果进行分析，并通过卡方检验探索 ICU 之间的差异。进行定性显式内容分析，以探讨写日记的目的。
所有 ICU（n=85）中，99%的 ICU 做出了回应，75%的 ICU 使用了日记。灵感的来源是同事，而不是科学数据。写日记的主要原因是帮助患者回忆 ICU 住院经历。在患者选择、随访的专职人员和照片使用方面，不同 ICU 水平之间存在差异。卡方检验分析结果与内容分析结果之间的比较显示，设定的单位目标和实现目标的活动之间存在不一致，但无法解释检测到的程序差异。
在瑞典，ICU 随访中使用日记的情况很常见。大多数使用了明确的目标和内容结构。然而，不同 ICU 之间的实践和患者招募存在差异。这些差异似乎不是基于循证数据，也不是基于正在进行的研究或评估，而仅仅是基于专业判断。由于 ICU 随访需要大量资源和时间，因此，对于患者选择的标准和 ICU 随访中日记的结构和使用指南，都需要明确规定。
