Department of Anaesthesia, ICU, Centralsjukhuset, Kristianstad, Sweden.
Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Nurs Crit Care. 2018 Nov;23(6):299-307. doi: 10.1111/nicc.12162. Epub 2015 May 25.
Many patients lack a clear recollection from their stay in the intensive care unit (ICU). Diaries have been introduced as a tool to complete memories and reduce the risk of posttraumatic stress disorder (PTSD).
To describe and compare patients' memories and PTSD in relation to having received and read or not received a diary and patients' experiences of having received and read their diary, without having discussed the contents with ICU staff.
Descriptive and comparative.
Patients received their diaries at ICU discharge. After 2 months patients answered the ICU Memory Tool, a screening instrument for PTSD (PTSS-14) and a questionnaire including space for own comments about the diaries.
Of 96 patients, 52(54%) received a diary, 44 did not. Patients with diaries had significantly longer stay and more mechanical ventilation. Of these, 40 patients responded to PTSS-14 and had evaluated and read the diary and 34 patients served as controls. No significant differences were found in presence/absence of memories between these groups. In the diary-group patients with emotional memories had lower APACHE. Feelings of being anxious or frightened were more common in the diary-group. At 2 months, 12% scored above cut-off on the PTSS14 with no difference between groups. The diaries were helpful for understanding the ICU-stay.
Diaries seem valuable in understanding what happened, as an act of caring and as a tool for discussion with relatives and friends. Patients valued reading their diaries. None expressed the wish to have read the diary together with a member of staff. The diary and non-diary groups however reported similar memories.
Diaries seem to be valuable in understanding what happened, giving a feeling of trust and for talking about their ICU-stay. As many patients described stressful memories, sessions should be offered with ICU staff.
许多患者在重症监护病房（ICU）住院期间缺乏清晰的记忆。日记已被引入作为一种补充记忆、降低创伤后应激障碍（PTSD）风险的工具。
描述和比较患者在接受和阅读日记与未接受和阅读日记的情况下的记忆和 PTSD，并比较患者对接受和阅读日记的体验，而不与 ICU 工作人员讨论日记内容。
描述性和比较性。
患者在 ICU 出院时收到日记。2 个月后，患者回答 ICU 记忆工具、创伤后应激障碍筛查工具（PTSS-14）和一份包括对日记的个人意见空间的问卷。
在 96 名患者中，52 名（54%）患者收到了日记，44 名患者没有收到。有日记的患者住院时间和机械通气时间明显延长。其中，40 名患者对 PTSS-14 进行了评估和阅读日记，34 名患者作为对照组。这些组之间在记忆存在/缺失方面没有发现显著差异。在日记组中，有情绪记忆的患者急性生理与慢性健康评分（APACHE）较低。在日记组中，感到焦虑或恐惧的感觉更为常见。2 个月时，12%的患者 PTSS14 评分超过临界值，两组之间无差异。日记有助于理解 ICU 住院情况。
日记在理解发生的事情、关心患者以及作为与亲属和朋友讨论的工具方面似乎很有价值。患者重视阅读自己的日记。没有人表示希望与工作人员一起阅读日记。然而，日记组和非日记组报告的记忆相似。
日记在理解发生的事情、建立信任感以及讨论 ICU 住院经历方面似乎很有价值。由于许多患者描述了有压力的记忆，应与 ICU 工作人员一起提供治疗方案。
