ICU Survivors Experience of ICU Diaries: An Ancillary Qualitative Analysis of the ICU Diary Study. (14th May 2021)

• Record Type: Journal Article
• Authors: Flahault, Cécile; Trosdorf, Mathilde; Sonrier, Marie; Vioulac, Christel; Fasse, Léonor; Timsit, Jean-François; Bailly, Sébastien; Garrouste-Orgeas, Maité
• Is Part Of: Critical care explorations. Volume 3:Number 5(2021)
• Page Start: e0384
• Publication Date: 2021-05-14
• Subjects: intensive care -- intensive care unit diary -- post-traumatic stress disorder -- psychological interview -- qualitative research
• DOI: 10.1097/CCE.0000000000000384
• Languages: English
• ISSNs: 2639-8028

Abstract

Abstract : Supplemental Digital Content is available in the text. Abstract : OBJECTIVES: To investigate patients' experience of ICU diaries 6 months after ICU discharge among survivors. This study was designed to add insight into a large randomized study, which found no benefit of the ICU diary to post-traumatic stress disorder among critically ill patients having received mechanical ventilation. DESIGN: A preplanned qualitative substudy of patients receiving an ICU diary written by ICU caregivers and families. Six months after ICU discharge, survivors were contacted by a psychologist for a telephone interview using a semi-directive guide. SETTING: Thirty-five French ICUs. PATIENTS: All ICU survivors having received an ICU diary. INTERVENTION: An ICU diary written by both ICU staff and families. MEASUREMENTS AND MAIN RESULTS: Among the 332 patients randomized in the intervention group (having had an ICU diary filled by both ICU staff and families), 191 (57.7%) were alive at 6 months and 101 of 191 (52.9%) participated in a telephone interview. They were (median [interquartile range]) 64 years old (53–70 yr old); 65 (64.4%) were men, and 79 (78.2%) were medical patients. Duration of ICU stay was 13 days (8–21 d). Three themes were derived from the thematic analysis: 1) reading the diary: between emotion and pain, 2) how the diary helped, and 3) the bittersweet representation of the diary. For half of the patients, the diary is a good memory of difficult times (55/101, 54.5%), others seem to be more ambivalent about it (28/101, 27.8%), and 37 of 101, 36.6% see it as a painful representation of a time to be forgotten. CONCLUSIONS: When reading their ICU diaries, ICU survivors experienced mixed emotions, related to family messages, medical caregiving, and to the severity of their illness. Patients described diaries as a help or a hindrance to recovery, depending on their wish to remember the period or move on from it.