Department of Language and Communication, University of Southern Denmark, Denmark.
Department of Anaesthesiology & Intensive Care, Odense University Hospital, Denmark; Department of Clinical Research, Research Unit in Anaesthesiology, University of Southern Denmark, Denmark.
Int J Nurs Stud. 2022 Dec;136:104363. doi: 10.1016/j.ijnurstu.2022.104363. Epub 2022 Sep 19.
Diaries written by nurses for critically ill patients have been implemented in some intensive care units as an intervention to construct patients' "lost time" and fill in their gaps in memory. Studies have shown that diaries have an impact on patients' psychological recovery after intensive care. However, little is known about how nurses view and carry out the process of writing a diary on behalf of a patient.
To investigate the choices nurses make in content and language, the rationale by which they make them, and how these narrative aspects shape the story of critical care that is constructed in the diary.
The study was conducted using a qualitative approach informed by narrative methodology.
Three intensive care units at a university hospital in Denmark.
Nine nurses with experience in diary writing. Each of the participants handed in five anonymized diary notes written for different patients they had cared for.
The study combined textual analysis of the diary notes and a thematic analysis of individual interviews with nurses about their narrative choices when writing the diary.
Three prominent strategies that characterize nurses' choices of content and language were identified: 1) Making the situation of intensive care more manageable, 2) Showing acts of perceiving the patient, and 3) Constituting relations through actions and interactions. The study showed that on one hand these strategies engage the patient and depict nurses' care, empathy and support, yet on the other, reveal the nurses' power to interpret, passivize and downplay the patient's experiences.
It was demonstrated that although the diary narrative is written about and for the patient, who is referred to and addressed as you, the nurse's interpretations, evaluations, perceptions, and actions figure prominently throughout the diary. Narrating for a you to some degree relegates the patients to a secondary position in their own diary. With the power to control the diary narrative, nurses' linguistic choices may either narrow down or expand possibilities for the patient's own understanding when reading the diary after intensive care. Permission to produce and store all data was obtained from the Danish Data Protection Agency (no. 18/60944).
在一些重症监护病房，护士为危重症患者撰写日记已作为一种干预措施实施，旨在构建患者的“失落时间”并填补其记忆空白。研究表明，日记对患者重症监护后的心理康复有影响。然而，对于护士如何看待和完成代表患者写日记的过程，我们知之甚少。
调查护士在内容和语言上的选择、做出这些选择的依据，以及这些叙述方面如何塑造在日记中构建的重症护理故事。
本研究采用定性方法，以叙事方法为依据。
丹麦一所大学医院的三个重症监护病房。
九名有写日记经验的护士。每位参与者提交了五份匿名日记记录，这些记录是为他们照顾过的不同患者撰写的。
该研究结合了对日记记录的文本分析和对护士撰写日记时叙事选择的个别访谈的主题分析。
确定了三个突出的策略，这些策略体现了护士在内容和语言选择方面的特点：1）使重症监护的情况更易于管理，2）展示对患者的感知行为，3）通过行动和互动构建关系。研究表明，一方面，这些策略使患者参与进来，并描绘了护士的关怀、同理心和支持，但另一方面，也揭示了护士的解释、被动化和淡化患者体验的权力。
虽然日记叙述是为患者撰写的，但患者被提及并被称为你，护士的解释、评估、感知和行为在整个日记中都占据重要地位。在某种程度上为你叙述会使患者在自己的日记中处于次要地位。由于控制日记叙述的权力，护士的语言选择可能会缩小或扩大患者在重症监护后阅读日记时的自我理解的可能性。获得丹麦数据保护局（编号 18/60944）的许可，可以制作和存储所有数据。
