Nielsen Anne Højager, Angel Sanne, Egerod Ingrid, Hansen Torben Bæk
1Department of Anesthesiology, Regional Hospital Holstebro, Lægårdvej 12, 7500 Holstebro, Denmark.
2Department of Clinical Medicine, Aarhus University, Incuba/Skejby, Building 2, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
BMC Nurs. 2018 Aug 16;17:37. doi: 10.1186/s12912-018-0306-y. eCollection 2018.
Critically ill patients and their relatives have complex needs for support during their stay in the intensive care unit (ICU) and the post-ICU rehabilitation period. Diaries written by nurses have proven beneficial for patients and relatives, preventing post-traumatic stress, anxiety and depression and helping patients and families find meaning. Actively involving relatives in writing a diary for critically ill patients is a new approach to helping relatives and patients cope; however, research is limited.The aim of this study is to test the hypothesis that a diary written by a close relative of a critically ill patient will reduce the risk of developing symptoms of post-traumatic stress disorder (PTSD) in the patient and relatives at 3 months post-ICU. Furthermore, the aim is to explore the perceptions and use of the diary and describe the diary content and structure.
The intervention consists of a hard-cover notebook that will be given to a close relative to write a diary for the critically ill patient while in the ICU. Guidance will be offered by ICU nurses on how to author the diary. The effect of the intervention will be tested in a two-arm, single-blind, randomized controlled trial, which aims to include 100 patient/relative pairs in each group. The primary outcome studied is symptoms of post-traumatic stress (PTSS-14). Secondary outcomes are scores on anxiety and depression (HADS) and the Medical Outcomes Study Questionnaire Short Form 36 (SF-36). The narrative structure and content of the diary as well as its use will be explored in two qualitative studies.
The results of this study will inform ICU nurses about the effects, strengths and limitations of prompting relatives to author a diary for the patient. This will allow the diary intervention to be tailored to the individual needs of patients and relatives.
NCT02357680. Registered September 3, 2015.
重症患者及其亲属在重症监护病房（ICU）住院期间以及ICU后的康复期有着复杂的支持需求。护士撰写的日记已被证明对患者及其亲属有益，可预防创伤后应激障碍、焦虑和抑郁，并帮助患者及其家人找到生活的意义。让亲属积极参与为重症患者撰写日记是帮助亲属和患者应对的一种新方法；然而，相关研究有限。本研究的目的是检验以下假设：重症患者的近亲撰写的日记将降低患者及其亲属在ICU后3个月出现创伤后应激障碍（PTSD）症状的风险。此外，目的是探索对日记的认知和使用情况，并描述日记的内容和结构。
干预措施包括一本硬皮笔记本，将其交给近亲，以便在患者在ICU期间为其撰写日记。ICU护士将提供有关如何撰写日记的指导。将在一项双臂、单盲、随机对照试验中测试干预措施的效果，该试验旨在每组纳入100对患者/亲属。研究的主要结局是创伤后应激症状（PTSS - 14）。次要结局是焦虑和抑郁评分（HADS）以及医学结局研究问卷简表36（SF - 36）。将在两项定性研究中探索日记的叙事结构、内容及其使用情况。
本研究的结果将让ICU护士了解促使亲属为患者撰写日记的效果、优点和局限性。这将使日记干预能够根据患者和亲属的个体需求进行调整。
NCT02357680。于2015年9月3日注册。
