Intensive Care Department, County Hospital, Kalmar, Sweden.
Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
Nurs Crit Care. 2019 Nov;24(6):407-413. doi: 10.1111/nicc.12416. Epub 2019 Jan 24.
Diaries as an intervention to aid psychological recovery among intensive care patients have been used for about 20 years, and findings tend to be positive. The provision of a diary directed at the patient may clarify the story of the intensive care unit (ICU) even for the family members and the family members of non-survivors. Members of nursing staff are the primary authors, but how they themselves experience the use of ICU diaries has been minimally explored.
This study aimed to explore how nursing staff experienced the use of ICU patient diaries.
Qualitative design using focus group interviews.
A qualitative methodology was used. Six focus group interviews were conducted with 27 nursing staff recruited from one university and two county hospitals. The data were analysed via thematic content analysis.
One overarching theme, 'An effort to do good in words and actions', and four interconnected themes were derived from the analysis. By creating the diary, nursing staff had to deal with a variety of ethical and practical dilemmas, but feedback from patients, family members and ICU follow-up services reinforced the feeling of doing good. This overarching feeling of beneficence encouraged diary authoring and increased motivation and commitment to strive towards excellent patient care. To sustain the use of ICU diaries, collegiate and organizational support was deemed essential.
Nursing staff strived to do good in words and actions for patients and their families when writing the diaries. Positive feedback from patients, family members and ICU follow-up services reinforced feelings of doing good, which served to enhance work satisfaction and a commitment to good-quality nursing care. Experiential-based education was recommended to help sustain ICU diary writing.
Nursing staff requested mentoring and group discussions concerning the format, content and communication channels of the diary.
近 20 年来，日记作为一种辅助重症监护患者心理康复的干预手段得到了广泛应用，研究结果往往是积极的。提供给患者的日记可以让患者和非幸存者的家属更清楚地了解重症监护病房（ICU）的故事。护理人员是主要的作者，但他们自己是如何体验使用 ICU 日记的，这方面的研究还很少。
本研究旨在探讨护理人员对使用 ICU 患者日记的体验。
使用焦点小组访谈的定性设计。
采用定性方法，从一所大学和两家县医院招募了 27 名护理人员，进行了 6 次焦点小组访谈。通过主题内容分析对数据进行分析。
从分析中得出一个总体主题，“努力用言语和行动做好事”，以及四个相互关联的主题。通过创建日记，护理人员不得不处理各种伦理和实际困境，但来自患者、家属和 ICU 随访服务的反馈加强了做好事的感觉。这种总体上的行善感鼓励写日记，并增强了对卓越护理的动力和承诺。为了维持 ICU 日记的使用，团队合作和组织支持被认为是必不可少的。
护理人员在写日记时努力为患者及其家属做好事。来自患者、家属和 ICU 随访服务的积极反馈增强了做好事的感觉，从而提高了工作满意度和对高质量护理的承诺。建议开展基于经验的教育，以帮助维持 ICU 日记的书写。
护理人员要求对日记的格式、内容和沟通渠道进行指导和小组讨论。
