title: Use and practice of patient diaries in Swedish intensive care units: a national survey.
abstract: OBJECTIVE
  To describe and compare the extent and application of patients' diaries in Sweden.
  
  
  BACKGROUND
  Since 1991, patient diaries have been used in intensive care unit (ICU) follow-up in Sweden. There is paucity of relevant data evaluating the effect of this tool and also on what premises patients are enrolled. Likewise, data are sparse on the diaries' design, content structure and the use of photographs.
  
  
  METHODS
  Descriptive explorative design by a semi-structured telephone interview.
  
  
  METHODS
  The interview results were analysed with descriptive statistics and differences between the ICU levels were explored by chi(2) analysis. Qualitative manifest content analysis was performed to explore the purpose of diary writing.
  
  
  RESULTS
  Of all ICUs (n = 85), 99% responded and 75% used diaries. The source of inspiration was collegial rather than from scientific data. The main reason for keeping a diary was to help the patient to recapitulate the ICU stay. Discrepancies between the different levels of ICUs were detected in patient selection, dedicated staff for follow-up and the use of photographs. Comparison between the chi(2) analysis and the content analysis outcome displayed incongruence between the set unit-goals and the activities for achievement but did not explain the procedural differences detected.
  
  
  CONCLUSIONS
  The uses of diaries in post ICU follow up were found to be common in Sweden. A majority used defined goals and content structure. However, there were differences in practice and patient recruitment among the levels of ICUs. These discrepancies seemed not to be based on evidence-based data nor on ongoing research or evaluation but merely on professional judgement. As ICU follow-up is resource intense and time consuming, it is paramount that solid criteria for patient selection and guidelines for the structure and use of diaries in post-ICU follow-up are defined.
authors.affiliation: Department of Intensive Care Medicine, Malmö University Hospital, 205 02 Malmö, Sweden. eva.akerman@gmail.com
authors.forename: Eva
authors.initials: E
authors.lastname: Akerman
authors.forename: Anetth
authors.initials: A
authors.lastname: Granberg-Axéll
authors.forename: Anders
authors.initials: A
authors.lastname: Ersson
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Bergbom
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001325:Autobiographies as Topic; D003422:Critical Care / Q000379:methods / Q000523:psychology; D016638:Critical Illness / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation; D003625:Data Collection; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D009042:Motivation; D033262:Narration; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D010781:Photography; D036301:Qualitative Research; D013041:Specialties, Nursing / Q000379:methods*; D011795:Surveys and Questionnaires; D013548:Sweden; D014956:Writing