title: Perspectives of patients and family members regarding psychological support using intensive care diaries: An exploratory mixed methods study.
abstract: Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what information delivery method is preferred.
  
  
  
  Intensive care patients admitted for at least 3 days and their relatives participated in an exploratory mixed methods study. Interviews were conducted 3 to 5 months after discharge. Psychological distress was assessed using Kessler-10 and Posttraumatic Stress Disorder Symptom Checklist - 5. Perceptions of benefit of diaries were assessed using a 4-point Likert scale. Differences were examined using Fisher exact test (P<.05).
  
  
  
  Fifty-seven patients and 22 relatives consented to participation, with 22 patients and 22 relatives interviewed before data saturation. Psychological distress was evident in 25 (47%) patients and 5 (23%) relatives. Participants' psychological health was similar for those who perceived diaries as beneficial, and those who did not. Themes included memory, process, and impact, although opinions were diverse.
  
  
  
  Patient and relative preferences of receiving a diary are not related to psychological distress. Diverse opinions around common themes suggest the need for a range of interventions to aid psychological recovery.
authors.affiliation: School of Health Sciences, City, University of London, United Kingdom; National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia. Electronic address: Leanne.aitken.1@city.ac.uk.
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Aitken
authors.affiliation: School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HJ, United Kingdom.
authors.forename: Janice
authors.initials: J
authors.lastname: Rattray
authors.affiliation: School of Psychology, University of Queensland, St Lucia 4072, Queensland, Australia; Recover Injury Research Centre, Level 7, Oral Health Building, The University of Queensland, Herston, Queensland 4029, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
authors.affiliation: Department of Psychiatry, University of Dundee, NHS Tayside, Perth, United Kingdom; Multidisciplinary Adult Psychotherapy Service, Perth Royal Infirmary, Perth PH1 1NX, United Kingdom.
authors.forename: Alastair M
authors.initials: AM
authors.lastname: Hull
authors.affiliation: National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Ullman
authors.affiliation: School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Queensland 4072, Australia.
authors.forename: Robyne
authors.initials: R
authors.lastname: Le Brocque
authors.affiliation: Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia; School of Nursing and Midwifery, NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland 4111, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Davis
authors.affiliation: Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Nathan, Queensland 4111, Australia.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Castillo
authors.affiliation: National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Macfarlane
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D001315:Australia; D003422:Critical Care / Q000523:psychology*; D016638:Critical Illness / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*
keywords: Anxiety; Depression; Intensive care; Intensive care diaries; Posttraumatic stress; Recovery