The intensive care unit diary as a valuable care tool: A qualitative study of patients' experiences

Abstract

Objectives: The aim is to learn about patients' experience of reading the diary, assess attributed meaning and explore patients' experience and memories during their stay in the intensive care unit.

Setting: Eleven patients who received the diary after a stay in a nine-bed cardiac intensive care unit in Southern Switzerland, from November 2019 to October 2021.

Main outcome measures: Descriptive qualitative research was performed using semi-structured interviews, followed by thematic analysis. Three research nurses conducted individual telephone or face-to-face interviews.

Findings: Fifteen sub-themes emerged from the data interviews and were grouped into five main categories: a) the experience in the intensive care unit; b) Post Intensive Care Syndrome symptoms; c) the patient diary; d) new meaning of life; and e) sharing. Patients showed difficulties in remembering and understanding what happened during the hospitalization period. Reading the diary enabled them to understand the impact that the illness had on their daily experience. For some of them, reading the diary was helpful in reacting positively during moments of discouragement.

Conclusion: Qualitative approach allowed us to assess how patients perceive the diary in the intensive care unit in a cultural context of Central and Southern Europe, which is still poorly investigated. The diary responded to the person's need to know what happened during a period that they had no memory of. Its use demonstrated important benefits, allowing people to understand the impact that the illness had on everyday life. It allowed them to relate to the difficulties encountered during the healing process. Thus, the diary played an important role during the healing process.

Implications for clinical practice: The diary was appreciated by patients during all stages of recovery from severe and acute illness. Gaps within the narration were avoided, in order to provide patients with a better timeline of the events occurred during the time they were unconscious.

Keywords: Critical Care Nursing; Diary; Intensive Care Unit; Memory; Narration; Perception; Post Intensive Care Syndrome; Qualitative research; Writing.