Nair Rajni, Mitchell Marion, Keogh Samantha
School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia.
Critical Care - Princess Alexandra Hospital and NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, Qld, Australia.
Aust Crit Care. 2015 May;28(2):93-102. doi: 10.1016/j.aucc.2014.09.001. Epub 2014 Oct 31.
Critical illness can be a psychological stressor for patients and family members. Scandinavian studies have portrayed patient diaries as a supporting catalyst for patients and their families through a process of reflection and fact presentation. However, the small number of randomisation trials exhibits theoretical and methodological limitations. Given the increased interest amongst Australian Critical Care Nurses, further understanding of nurses' perceptions and use of patient diaries was warranted.
To identify nurses' perceptions of patient diary use and to describe their application within Australian ICUs.
A descriptive, exploratory study design using an online survey of the Australian College of Critical Care Nurses was used. Descriptive statistics illustrated participant responses and textual data were subjected to content analysis for emergent themes.
Out of the 194 participants, 19% (n=37) reported patient diary use in their unit, with nine indicating some form of evaluation. Fifty (70%) of the non-diary users, who responded, indicated hesitancy to introduce them. Respondents noted a lack of guiding policies and potential medico-legal ambiguity. Content analysis revealed three themes, considering diaries as: communication tool, patient recovery tool and a family centred care strategy.
Patient diary use appears to be in its infancy in Australia with a lack of guiding policy for format and processes including evaluation. Nurses using diaries were enthusiastic about the initiative, holding optimistic perceptions about the potential positive impact of diaries on patient and family outcomes. Further research on their efficacy is required.
危重病对患者及其家属来说可能是一种心理压力源。斯堪的纳维亚的研究将患者日记描述为通过反思和事实呈现过程对患者及其家属起到支持促进作用的因素。然而，少数随机试验存在理论和方法上的局限性。鉴于澳大利亚重症监护护士对此兴趣增加，有必要进一步了解护士对患者日记的看法及使用情况。
确定护士对使用患者日记的看法，并描述其在澳大利亚重症监护病房中的应用情况。
采用描述性、探索性研究设计，对澳大利亚重症监护护士学院进行在线调查。描述性统计说明了参与者的回答情况，文本数据进行了内容分析以找出新出现的主题。
在194名参与者中，19%（n = 37）报告其所在科室使用了患者日记，其中9人表示进行了某种形式的评估。在回复的非日记使用者中，50人（70%）表示对引入日记有所犹豫。受访者指出缺乏指导政策以及潜在的医疗法律模糊性。内容分析揭示了三个主题，即将日记视为：沟通工具、患者康复工具和以家庭为中心的护理策略。
在澳大利亚，患者日记的使用似乎尚处于起步阶段，缺乏关于格式和流程（包括评估）的指导政策。使用日记的护士对这一举措充满热情，对日记对患者和家庭结局的潜在积极影响持乐观看法。需要对其效果进行进一步研究。
