Dimens Crit Care Nurs. 2022;41(5):256-263. doi: 10.1097/DCC.0000000000000539.
Patients discharged from the intensive care unit (ICU) suffer from long-term symptoms affecting the physical, psychological, and cognitive well-being and cannot understand memories and dreams. Intensive care unit diaries describe daily events about the patient and may allow them to reconstruct their experience.
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ICU diaries on posttraumatic stress disorder (PTSD), depression, and anxiety.
Five electronic databases were searched up to May 6, 2022. We included RCTs comparing patients admitted to the ICU who received a diary to those who did not receive a diary. The primary outcome was the rate of PTSD. Secondary outcomes were rates of depression and anxiety.
We included 7 RCTs. Patients who received a diary during the ICU admission had reduced rate of PTSD (78/432 [18%] vs 106/422 [25%]; risk ratio [RR], 0.73; 95% confidence interval [CI], 0.57-0.94; P = .02; I2 = 0%; trial sequential analysis-adjusted CI, 0.55-0.97) when compared with patients who did not receive a diary. We found a non-statistically significant difference toward a reduction in the rate of depression (38/232 [16%] vs 54/224 [24%]; RR, 0.70; 95% CI, 0.49-1.01; P = .06; I2 = 0%) and anxiety (63/232 [27%] vs 70/224 [31%]; RR, 0.64; 95% CI, 0.29-1.40; P = .26; I2 = 67%).
Providing an ICU diary to patients admitted to the ICU reduced the rate of PTSD symptoms compared with usual care.
从重症监护病房（ICU）出院的患者会遭受长期影响身体、心理和认知健康的症状，并且无法理解记忆和梦境。重症监护病房日记描述了有关患者的日常事件，可能使他们能够重建自己的经历。
我们进行了系统评价和随机对照试验（RCT）的荟萃分析，以调查 ICU 日记对创伤后应激障碍（PTSD）、抑郁和焦虑的影响。
截至 2022 年 5 月 6 日，我们检索了 5 个电子数据库。我们纳入了将 ICU 住院患者分为接受日记组和不接受日记组的 RCT。主要结局是 PTSD 发生率。次要结局是抑郁和焦虑发生率。
我们纳入了 7 项 RCT。与未接受日记组相比，接受 ICU 住院期间日记的患者 PTSD 发生率降低（78/432 [18%] 比 106/422 [25%]；风险比 [RR]，0.73；95%置信区间 [CI]，0.57-0.94；P =.02；I2 = 0%；试验序贯分析调整的 CI，0.55-0.97）。我们发现，在降低抑郁发生率方面，差异无统计学意义（38/232 [16%] 比 54/224 [24%]；RR，0.70；95% CI，0.49-1.01；P =.06；I2 = 0%）和焦虑发生率（63/232 [27%] 比 70/224 [31%]；RR，0.64；95% CI，0.29-1.40；P =.26；I2 = 67%）。
与常规护理相比，向 ICU 住院患者提供 ICU 日记可降低 PTSD 症状发生率。
