Dimens Crit Care Nurs. 2021;40(4):248-256. doi: 10.1097/DCC.0000000000000480.
The aim of this study was to investigate the implementation of an intensive care unit (ICU) diary in an Italian general ICU.
A mixed-methods pilot study was performed, enrolling all patients who received an ICU diary in an Italian ICU during the study period.
Study results are presented in 2 sections: (1) diary evaluation and content themes and (2) follow-up program results. Sixty-six patients were assessed for eligibility. Diary administration was possible in 31 patients (47%). The overall diary entries, in 31 analyzed diaries, were 1331, with a median of 25 entries (interquartile range, 16-57 entries) for each diary. Participants' relatives and friends wrote a median of 1.2 (0.3-1.6), and nurses wrote 1.1 (0.8-1.2). Other ICU staff wrote a total of 24 entries (2%). Follow-up results revealed low incidence of delirium detected in only 1 patient at the 7-day visit (3%). The median value of PTSS-10 (Post Traumatic Stress Symptoms) score was 12 (3.5-12) at the 7-day visit, 6 (1.5-12) at 3 months' telephone interview, and 12 (1.5-17) at 6 months' visit.
To our knowledge, this is the first Italian report about the introduction of an ICU diary. The diaries were easily implemented in our clinical practice as a "low-cost" initiative. In our study, nurses and participants' relatives and friends wrote a similar number of entries in each analyzed diary. This project could be effective in reducing survivors' delirium and post-traumatic stress disorder and in implementing mutual understanding between clinical staff and relatives during ICU stay.
本研究旨在调查意大利普通重症监护病房（ICU）中 ICU 日记的实施情况。
采用混合方法进行试点研究，纳入研究期间在意大利 ICU 接受 ICU 日记的所有患者。
研究结果分为两部分呈现：（1）日记评估和内容主题，（2）随访计划结果。共有 66 名患者符合入选标准。31 名患者（47%）可进行日记管理。在 31 份分析日记中，共记录了 1331 次日记条目，每份日记的中位数为 25 次（四分位间距，16-57 次）。参与者的亲属和朋友平均每人写了 1.2 次（0.3-1.6 次），护士写了 1.1 次（0.8-1.2 次）。其他 ICU 工作人员共写了 24 次（2%）。随访结果显示，仅在第 7 天访视时发现 1 例患者存在轻度谵妄（3%）。第 7 天访视时，创伤后应激症状 10 项量表（PTSS-10）评分中位数为 12（3.5-12），3 个月电话访谈时为 6（1.5-12），6 个月访视时为 12（1.5-17）。
据我们所知，这是意大利首例关于引入 ICU 日记的报告。在我们的临床实践中，这些日记很容易实施，是一项“低成本”的举措。在我们的研究中，护士和参与者的亲属和朋友在每篇分析日记中记录的条目数量相似。该项目可能有助于减少幸存者的谵妄和创伤后应激障碍，并在 ICU 期间促进临床工作人员和亲属之间的相互理解。
