University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark.
Crit Care Med. 2011 Aug;39(8):1922-8. doi: 10.1097/CCM.0b013e31821e89c8.
After a stay in the intensive care unit, patients risk experiencing delusional memories, memory loss, and symptoms of posttraumatic stress. Since the 1990s, diaries have been kept for intensive care unit patients to help fill in memory gaps, aid psychosocial recovery, and improve health-related quality of life. More insight is needed into the application of diaries. The aim of our study was to explore how patients and relatives use diaries in the context of the illness trajectory.
Qualitative multicentered design using in-depth semistructured interview technique.
A nine-bed general intensive care unit and a 13-bed thoracic surgical intensive care unit in Denmark.
A sample of 19 patients at 6-12 months postintensive care unit discharge and 13 relatives (n = 32).
Intensive care diaries and handover 1 or 3 months postintensive care unit discharge.
Grounded theory method was used to explore the use of diaries as a psychosocial process of recovery involving patients and relatives. Data were managed by NVivo software. The core category was "constructing the illness narrative," which was a process of narration embedded in our emerging theory of psychosocial recovery after critical illness. The main categories within the patient perspective were information acquisition and gaining insight, and the main categories within the relative perspective were supporting the patient, supporting oneself, and negotiating access.
Intensive care diaries are useful to patients as well as their relatives. Patients need to construct their illness narrative, and diaries are among the sources they use. The patients' project was to combine various sources of information in a process of information acquisition, narration, and evolving insight progressing toward recovery. The relatives supported the patients' project and also supported themselves by using the diary to uphold their own healing process. We recommend intensive care diaries as a low-technology, low-cost rehabilitative intervention for patients and relatives to help bridge the span from intensive care to recovery.
在重症监护病房（ICU）停留后，患者可能会出现幻觉记忆、记忆丧失和创伤后应激症状。自 20 世纪 90 年代以来，人们为 ICU 患者写日记，以帮助填补记忆空白，促进心理社会康复，并提高与健康相关的生活质量。需要更多地了解日记的应用。本研究旨在探讨患者和亲属在疾病轨迹背景下如何使用日记。
定性多中心设计，采用深度半结构化访谈技术。
丹麦的一家 9 床普通 ICU 和一家 13 床胸外科 ICU。
19 名患者在 ICU 出院后 6-12 个月，13 名亲属（n=32）。
ICU 日记和 ICU 出院后 1 或 3 个月的交接。
采用扎根理论方法探讨日记作为涉及患者和亲属的康复心理社会过程的使用。数据由 NVivo 软件管理。核心类别是“构建疾病叙事”，这是一个嵌入我们关于重症疾病后心理社会康复的新兴理论的叙述过程。患者视角的主要类别是信息获取和获得洞察力，亲属视角的主要类别是支持患者、支持自己和协商获取。
重症监护日记对患者及其亲属都很有用。患者需要构建自己的疾病叙事，日记是他们使用的信息来源之一。患者的项目是在信息获取、叙述和不断发展的洞察力过程中，将各种来源的信息结合起来，朝着康复的方向发展。亲属支持患者的项目，并通过使用日记来支持自己，从而维持自己的康复过程。我们建议将重症监护日记作为一种低技术、低成本的康复干预措施，供患者和亲属使用，以帮助弥合从重症监护到康复的差距。
