How diaries written for critically ill influence the relatives: a systematic review of the literature.
BACKGROUND
Diaries written by nurses for the critically ill patient helps relatives cope and support the patient. When relatives participate in writing a diary for the critically ill, patients appreciate it. Furthermore, the diary may reduce post-traumatic stress disorder, anxiety and depression in patients and relatives.


OBJECTIVE
To explore how relatives perceive reading and writing in the diary and how it affects their well-being.


METHODS
A systematic search was carried out in the databases PubMed, Embase, CiNAHL and PsycINFO and supplemented by a citation search in Scopus on four-selected articles. Finally, 10 articles were included in this review structured by the Matrix method.


METHODS
(a) Original scientific work, (b) relatives participation and experience of the diary as subject and (c) diaries studied in an intensive care unit setting.


RESULTS
Relatives were given instructions on how to write in the diary. They expressed strong feelings in the diary in a very different way than health care staff. The relatives used the diary themselves to gain understanding and to cope. The diary has been shown to prevent post-traumatic stress symptoms.


CONCLUSIONS
The relatives express their love for the patient, when they author the diary and this may be beneficial to the relatives as it helps them cope and support the patient. The organized account of the time in the intensive care unit in the diary may explain the diary's ability to reduce the occurrence of post-traumatic stress disorder; however, further research is needed to confirm this. How relatives interact through writing and reading a diary, originally intended for the patient, is unclear.


CONCLUSIONS
Providing relatives with a diary may help them cope. However, caution should be taken as possible adverse effects related to the interaction between relatives in the diary may not yet be known.
Department of Anesthesiology, Regional Hospital of West Jutland, Holstebro, Denmark.
Anne H
AH
Nielsen
Department of Nursing Science, Institute of Public Health, Aarhus University, Denmark.
Sanne
S
Angel
D003422:Critical Care / Q000523:psychology*; D016638:Critical Illness / Q000451:nursing*; D005190:Family / Q000523:psychology*; D006801:Humans; D007362:Intensive Care Units; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control; D014956:Writing
Comprehensive literature reviews; Critical care nursing; Family care in critical care; Relatives