title: The extent and application of patient diaries in Australian intensive care units: a national survey.
abstract: BACKGROUND
  Critical illness can be a psychological stressor for patients and family members. Scandinavian studies have portrayed patient diaries as a supporting catalyst for patients and their families through a process of reflection and fact presentation. However, the small number of randomisation trials exhibits theoretical and methodological limitations. Given the increased interest amongst Australian Critical Care Nurses, further understanding of nurses' perceptions and use of patient diaries was warranted.
  
  
  OBJECTIVE
  To identify nurses' perceptions of patient diary use and to describe their application within Australian ICUs.
  
  
  METHODS
  A descriptive, exploratory study design using an online survey of the Australian College of Critical Care Nurses was used. Descriptive statistics illustrated participant responses and textual data were subjected to content analysis for emergent themes.
  
  
  RESULTS
  Out of the 194 participants, 19% (n=37) reported patient diary use in their unit, with nine indicating some form of evaluation. Fifty (70%) of the non-diary users, who responded, indicated hesitancy to introduce them. Respondents noted a lack of guiding policies and potential medico-legal ambiguity. Content analysis revealed three themes, considering diaries as: communication tool, patient recovery tool and a family centred care strategy.
  
  
  CONCLUSIONS
  Patient diary use appears to be in its infancy in Australia with a lack of guiding policy for format and processes including evaluation. Nurses using diaries were enthusiastic about the initiative, holding optimistic perceptions about the potential positive impact of diaries on patient and family outcomes. Further research on their efficacy is required.
authors.affiliation: School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia. Electronic address: raj2497@yahoo.co.in.
authors.forename: Rajni
authors.initials: R
authors.lastname: Nair
authors.affiliation: Critical Care - Princess Alexandra Hospital and NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, Qld, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, Qld, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Keogh
mesh_terms: D000328:Adult; D001315:Australia; D064648:Critical Care Nursing; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D033262:Narration; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Caregiver; Critical care; Diary or diaries; Family; ICU; Patient; Psychological status; Relative