TY - JOUR
T1 - The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives
T2 - A randomised controlled trial (DRIP-study)
AU - Nielsen, Anne Højager
AU - Angel, Sanne
AU - Egerod, Ingrid
AU - Lund, Trine Højfeldt
AU - Renberg, Marianne
AU - Hansen, Torben Bæk
N1 - Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
PY - 2020/3
Y1 - 2020/3
N2 - BACKGROUND: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial.OBJECTIVES: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient.METHODS: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge.RESULTS: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8-% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: -15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life.CONCLUSION: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.
AB - BACKGROUND: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial.OBJECTIVES: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient.METHODS: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge.RESULTS: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8-% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: -15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life.CONCLUSION: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.
KW - Critical care
KW - Critical care nursing
KW - Family nursing
KW - Intensive care diaries
KW - Posttraumatic
KW - Stress disorders
U2 - 10.1016/j.aucc.2019.01.004
DO - 10.1016/j.aucc.2019.01.004
M3 - Journal article
C2 - 30795978
SN - 1036-7314
VL - 33
SP - 123
EP - 129
JO - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
IS - 2
ER -