Schofield Rachel, Dibb Bridget, Coles-Gale Rebecca, Jones Christina J
University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK.
University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK.
Int J Nurs Stud. 2021 Jul;119:103927. doi: 10.1016/j.ijnurstu.2021.103927. Epub 2021 Mar 19.
Intensive care patient diaries written by staff and/or relatives are widely used in intensive care units (ICUs) across the world. Although the original aim of the diaries was to support patients in their recovery from ICU, a more recent focus of the literature has been the potential benefit of the diaries to the relatives of patients. Meta-analyzes of quantitative studies looking at the impact on the psychological wellbeing of relatives have not consistently found an effect of the diaries, even though qualitative studies suggest that relatives find the diaries to be a useful coping strategy.
To evaluate and synthesise qualitative studies looking at the experience of relatives writing in ICU diaries.
A systematic review and qualitative synthesis.
A structured search using CINAHL, MEDLINE, PsycInfo, Cochrane Central Register of Controlled Trials (CENTRAL), PTSDHubs and Published International Literature Web of Science Conference Proceedings Citation Index - Science and Social Science and Humanities was conducted.
All studies published at any time that included qualitative data (including mixed methods studies) about the perceptions of relatives using ICU patient diaries were included. Themes and narrative statements were extracted from included articles and synthesised. Articles were quality assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist and Mixed Methods Appraisal Tool (MMAT).
Sixteen studies were included in the review, thirteen qualitative and three mixed methods articles. The themes identified were: 1. Coping (subthemes: 1.1. Emotion-Focused Coping and 1.2. Problem-Focused Coping) 2. Connection (subthemes: 2.1 Method of Communication and 2.2 Developing and maintaining relationships) 3. Developing a Narrative (subthemes 3.1 Understanding 3.2 Shaping the story 3.3 Remembering).
Relatives use the diaries in a variety of ways including as a means of coping, a way of staying connected, as a tool to understand and develop a narrative about the experience. These findings link the use of ICU diaries with literature on written emotional exposure, post-traumatic growth and meaning making. The relationship between a relative's use of the ICU diary, coping strategies and/or post-traumatic growth could be a focus for future quantitative trials. PROSPERO protocol number CRD42020165869.
由医护人员和/或亲属撰写的重症监护患者日记在全球重症监护病房（ICU）中广泛使用。尽管这些日记最初的目的是帮助患者从ICU康复，但最近文献关注的焦点是日记对患者亲属的潜在益处。对观察日记对亲属心理健康影响的定量研究进行的荟萃分析并未始终发现日记有显著效果，尽管定性研究表明亲属认为日记是一种有用的应对策略。
评估和综合关于亲属撰写ICU日记体验的定性研究。
系统评价和定性综合分析。
使用CINAHL、MEDLINE、PsycInfo、Cochrane对照试验中心注册库（CENTRAL）、PTSDHubs以及已发表的国际文献科学网会议论文引文索引 - 科学与社会科学及人文科学进行结构化检索。
纳入所有在任何时间发表的、包含关于亲属使用ICU患者日记看法的定性数据（包括混合方法研究）的研究。从纳入的文章中提取主题和叙述性陈述并进行综合分析。使用批判性评价技能计划（CASP）定性检查表和混合方法评价工具（MMAT）对文章进行质量评估。
该综述纳入了16项研究，其中13篇定性研究文章和3篇混合方法研究文章。确定的主题有：1. 应对（子主题：1.1. 以情绪为中心的应对和1.2. 以问题为中心的应对）2. 联系（子主题：2.1. 沟通方式和2.2. 发展和维持关系）3. 构建叙述（子主题3.1. 理解3.2. 塑造故事3.3. 回忆）。
亲属以多种方式使用日记，包括作为一种应对手段、保持联系的方式、理解和构建关于这段经历叙述的工具。这些发现将ICU日记的使用与关于书面情感暴露、创伤后成长和意义构建的文献联系起来。亲属使用ICU日记、应对策略和/或创伤后成长之间的关系可能是未来定量试验的重点。国际前瞻性系统评价注册库（PROSPERO）注册号：CRD42020165869。
