Department of Anesthesiology and Critical Care Medicine, Charlotte R. Bloomberg Children's Center, Johns Hopkins University School of Medicine, Baltimore, MD.
Pediatr Crit Care Med. 2019 Feb;20(2):e83-e90. doi: 10.1097/PCC.0000000000001814.
To determine the feasibility of implementing an ICU diary in the pediatric critical care setting and to understand the perceptions held by family members who receive the diaries after PICU discharge.
Observational pilot study.
PICU in a tertiary academic hospital in the United States.
Critically ill pediatric patients admitted to the PICU and their families.
The addition of a PICU diary to a patient's routine care.
Twenty families of critically ill children admitted to the PICU were enrolled in the PICU diary pilot study between May 2017 and March 2018. Patients who had an anticipated length of stay of at least 3 days and whose families were English-speaking were included. The median age of patients was 6 years, ranging from newborns to 18 years old, and the median length of stay was 11.5 days (interquartile range, 8.5-41 d). A total of 453 diary entries were written in 19 diaries over 433 PICU days, the majority of which were composed by bedsides nurses (63%). Follow-up surveys sent to parents 2 weeks after PICU discharge revealed that of the parents who had contributed to the diary, most enjoyed doing so (7/8). Nine of 12 parents had reviewed the diary at least once since discharge, and all parent respondents found the diary to be a beneficial aspect of their experience after PICU discharge.
The use of ICU diaries in the PICU setting is feasible and perceived as beneficial by families of critically ill children. Future studies are needed to better understand if PICU diaries may objectively improve psychologic outcomes of patients and family members after PICU admission.
确定在儿科重症监护病房实施 ICU 日记的可行性,并了解 PICU 出院后收到日记的家属的看法。
观察性试点研究。
美国一家三级学术医院的 PICU。
入住 PICU 的危重症儿科患者及其家属。
在患者常规护理中添加 PICU 日记。
2017 年 5 月至 2018 年 3 月期间,对入住 PICU 的 20 名危重症儿童的家属进行了 PICU 日记试点研究。纳入标准为预计住院时间至少 3 天且家属为英语使用者的患者。患者的中位年龄为 6 岁,从新生儿到 18 岁不等,中位住院时间为 11.5 天(四分位距,8.5-41 天)。在 433 个 PICU 日中,共写了 19 本日记,总计 453 篇日记,其中大部分由床边护士撰写(63%)。PICU 出院后 2 周发送的随访调查显示,在参与写日记的家长中,大多数人对此感到满意(7/8)。12 名家长中有 9 名自出院后至少查看过一次日记,所有家长受访者都认为日记是他们 PICU 出院后经历的有益方面。
在 PICU 环境中使用 ICU 日记是可行的,并且受到危重症儿童家属的认可。需要进一步的研究来更好地了解 PICU 日记是否可以客观改善患者和家属在 PICU 入院后的心理结局。