Analysis of patient diaries in Danish ICUs: a narrative approach.
OBJECTIVE
The objective was to describe the structure and content of patient diaries written for critically ill patients in Danish intensive care units (ICUs).


BACKGROUND
Critical illness is associated with physical and psychological aftermath including cognitive impairment and post-traumatic stress. Patient diaries written in the intensive care unit are used to help ICU-survivors come to terms with their illness.


METHODS
The study had a qualitative, descriptive and explorative design, using a narrative approach of analysis. Data were analysed on several levels: extra-case level, case level, diary-entry level, and sub-entry level. The sample consisted of 25 patient diaries written by critical care nurses in 2007 for patients at a general ICU in Denmark.


RESULTS
The base narrative describes three stages: crisis, turning point, and normalisation. Each case includes parallel plots of nurse, patient and family, which converge during normalisation. Each diary is structured by: summary, daily entries and end note. Each diary entry is structured by: greeting, narrator status, patient status, family status/contextual cues and sign-off note.


CONCLUSIONS
Patient diaries acknowledge the patient experience and provide new insights into nursing performance. This study offers a framework for understanding ICU patient diaries, which may facilitate cross-unit comparisons and support future guideline development. The dual perspectives of patient diaries and the ambiguous ownership of the narratives may pave the way for insights to improve critical care nursing and ICU rehabilitation.
Egerod
Ingrid
I
The University Hospitals Centre for Nursing and Care Research (UCSF), Rigshospitalet Department 7331, University of Copenhagen, Faculty of Health Sciences, Denmark. ie@ucsf.dk
Christensen
Doris
D
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology*; D016638:Critical Illness / Q000523:psychology*; D003718:Denmark; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008016:Life Change Events; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D033262:Narration; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D036301:Qualitative Research; D011795:Surveys and Questionnaires