Anne Højager Nielsen1,2, Sanne Angel3, Torben Baek Hansen4, Ingrid Egerod5,6. 1. Department of Anesthesiology, Regional Hospital Holstebro, Holstebro, Denmark. 2. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 3. Section for Nursing, Department of Public Health, Aarhus University, Aarhus, Denmark. 4. University Clinic for Hand, Hip and Knee Surgery, Regional Hospital Holstebro, Aarhus University, Aarhus, Denmark. 5. Health and Medical Sciences, University of Copenhagen, Aarhus, Denmark. 6. Intensive Care Unit 4131, Rigshospitalet, Copenhagen, Denmark.
Abstract
AIM: To investigate structure and content of a nurse prompted diary written by relatives for intensive care unit (ICU) patients. DESIGN: A narrative analysis of ICU diaries. METHODS: From September 2015-August 2016, 12 diaries authored by 12 relatives for 12 ICU patients were sampled at 3-4 months post-ICU discharge. We used Ricoeur's hermeneutical phenomenology as a framework for a narrative analysis of the diaries. The first step was naïve reading, followed by structural analysis exploring the internal relations of the text. The structural analysis was broadened by exploring narrative structures. The last step was critical interpretation of the findings. FINDINGS: The diaries had a clear narrative structure; the diary-timeline consisted of: Pre-ICU phase, Early ICU phase, Culmination, Recovery and Post-ICU reflection. Three themes described the content of the diary: Struggling to get the story right for the patient; striving to understand what was happening and longing to re-establish a connection with the patient. Keeping a diary was perceived by the relatives as a challenging but rewarding task. CONCLUSION: The diary had the potential for reflection and a deeper understanding of the ICU stay. The diary served as a locus for patient and relatives to connect or re-connect, but some diaries might be too personal and emotional to share with the patient. Future research needs to explore advantages and disadvantages of ICU diaries authored by relatives.
AIM: To investigate structure and content of a nurse prompted diary written by relatives for intensive care unit (ICU) patients. DESIGN: A narrative analysis of ICU diaries. METHODS: From September 2015-August 2016, 12 diaries authored by 12 relatives for 12 ICU patients were sampled at 3-4 months post-ICU discharge. We used Ricoeur's hermeneutical phenomenology as a framework for a narrative analysis of the diaries. The first step was naïve reading, followed by structural analysis exploring the internal relations of the text. The structural analysis was broadened by exploring narrative structures. The last step was critical interpretation of the findings. FINDINGS: The diaries had a clear narrative structure; the diary-timeline consisted of: Pre-ICU phase, Early ICU phase, Culmination, Recovery and Post-ICU reflection. Three themes described the content of the diary: Struggling to get the story right for the patient; striving to understand what was happening and longing to re-establish a connection with the patient. Keeping a diary was perceived by the relatives as a challenging but rewarding task. CONCLUSION: The diary had the potential for reflection and a deeper understanding of the ICU stay. The diary served as a locus for patient and relatives to connect or re-connect, but some diaries might be too personal and emotional to share with the patient. Future research needs to explore advantages and disadvantages of ICU diaries authored by relatives.