title: Images of suffering depicted in diaries of family caregivers in the acute stage of necrotising soft tissue infection: A content analysis.
abstract: OBJECTIVE
  Severe necrotising soft tissue infections (NSTI) are rare life threatening rapidly progressing bacterial infections requiring immediate diagnosis and treatment. The aim of the study was to explore the experience of family caregivers of patients with necrotising soft tissue infection during the acute stage of disease.
  
  
  METHODS
  Our study had a qualitative descriptive binational design using qualitative content analysis to explore diaries written by close family members (n=15). Participants were recruited from university hospitals in Denmark and Sweden.
  
  
  RESULTS
  Three main categories emerged: Trajectory, Treatment, and Patient & Family. The first helped us construct an overview of the NSTI trajectory showing issues of importance to patient and family caregivers. The following categories were analysed further to describe four themes central to the family caregiver experience: craving information, needing to be near, suffering separation and network taking over.
  
  
  CONCLUSIONS
  Necrotising soft tissue infections are uncommon causing shock and concern. Centralised treatment might involve physical separation of patient and family during the acute stage of illness. Family accommodations near the patient and accessibility to adequate communication devices at the bedside are recommended. Health professionals need to keep in mind the importance of information and reassurance on the wellbeing of the family and ultimately of the patient.
authors.affiliation: University of Copenhagen, Rigshospitalet, Intensive Care Unit 4131, Blegdamsvej 9, Copenhagen, Denmark,. Electronic address: ingrid.egerod@regionh.dk.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Egerod
authors.affiliation: Institute of Health and care science, University of Gothenburg, Sweden; Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden. Electronic address: annette.erichsen.andersson@gu.se.
authors.forename: Annette E
authors.initials: AE
authors.lastname: Andersson
authors.affiliation: Ann-Mari Fagerdahl: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden. Electronic address: ann-mari.fagerdahl@ki.se.
authors.forename: Ann-Mari
authors.initials: AM
authors.lastname: Fagerdahl
authors.affiliation: University of Copenhagen, Rigshospitalet, Intensive Care Unit 4131, Blegdamsvej 9, Copenhagen, Denmark,. Electronic address: vibeke.knudsen@regionh.dk.
authors.forename: Vibeke E
authors.initials: VE
authors.lastname: Knudsen
mesh_terms: D000208:Acute Disease / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003718:Denmark; D005260:Female; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D008016:Life Change Events; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009336:Necrosis / Q000150:complications / Q000523:psychology; D036301:Qualitative Research; D018461:Soft Tissue Infections / Q000150:complications / Q000523:psychology*; D013548:Sweden
keywords: Diary; Family caregiver; Family-centered critical care; Hyperbaric oxygen therapy; Intensive care unit; Necrotising soft tissue infection