title: Family members' experiences of keeping a diary during a sick relative's stay in the intensive care unit: a hermeneutic interview study.
abstract: OBJECTIVE
  The aim of the study was to explore family members' experiences with keeping a diary during a sick relative's stay in the ICU.
  
  
  METHODS
  A qualitative method with a hermeneutic approach was used. Eleven participants, who recorded nine diaries in total, were interviewed. The collected data were analysed using a hermeneutic approach inspired by Gadamer.
  
  
  RESULTS
  The analysis revealed a meta-theme: 'it [writing in the diary] felt like contact' which was created by a feeling of togetherness and the opportunity to communicate with the patient. Keeping a diary likely meets the needs of family members in several ways because it becomes a way to be present at the patient's bedsides, to provide caregiving, to maintain hope and to relay cogent information. However, concerns regarding negative aspects of diary keeping were also raised; for example, the diary created feelings of stress, guilt and failure and exposed intimate details.
  
  
  CONCLUSIONS
  The diary symbolised the maintenance of relationships with the patients and was a substitute for the usual opportunities for communication. Furthermore, it was instrumental in meeting the needs of the majority of family members in several ways. Nevertheless, the diary did have negative effects for certain individuals, which highlights the importance of an individualised approach.
authors.affiliation: Intensive Care Department, County Hospital, Kalmar, Sweden; Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden. Electronic address: maria.kantarellgatan@telia.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Johansson
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; School of Nursing & Midwifery, Sheffield S1 4DP, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hanson
authors.affiliation: Faculty of Health and Life Sciences, Linnaeus University, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Runeson
authors.affiliation: Intensive Care Department, County Hospital, Kalmar, Sweden; Research Section, Kalmar County Council, Kalmar, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Wåhlin
mesh_terms: D000328:Adult; D016638:Critical Illness; D004282:Documentation; D005190:Family / Q000523:psychology*; D005260:Female; D006167:Guilt; D066297:Hermeneutics; D065026:Hope; D006801:Humans; D007362:Intensive Care Units; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: Diaries; Experiences; Gadamer; Hermeneutics; ICU; Relatives