Aloud real- time reading of intensive care unit diaries: A feasibility study |
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| Affiliation: | 1. Department of Pulmonary and Critical Care, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA;2. Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA;3. Department of Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA;4. Department of Anesthesia and Critical Care, Arnold-Heller-Str. 3, University Hospital Schleswig-Holstein, Kiel 24105, Germany;5. Department of Psychiatry and Psychology, 200 First St SW, Mayo Clinic, Rochester, MN 55905, USA;1. Department of Emergency Medicine, Niguarda Ca'' Granda, Milan, Italy;2. Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy;3. Department of Anesthesia and Intensive Care Medicine, Niguarda Ca'' Granda, Milan, Italy;1. Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey;2. Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey;3. Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Health Application and Research Center, University of Health Sciences Turkey, Istanbul, Turkey;1. College of Nursing Art and Science, University of Hyogo, Akashi, Hyogo 673-0021, Japan;2. Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan;3. School of Nursing, Kitasato University, Sagamihara, Kanagawa 252-0329, Japan |
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| Abstract: | ObjectivesMemories of frightening/delusional intensive care unit experiences are a major risk factor for subsequent psychiatric morbidity of critical illness survivors; factual memories are protective. Systematically providing factual information during initial memory consolidation could mitigate the emotional character of the formed memories. We explored feasibility and obtained stakeholder feedback of a novel approach to intensive care unit diaries whereby entries were read aloud to the patients right after they were written to facilitate systematic real time orientation and formation of factual memories.Research methodologyProspective interventional pilot study involving reading diary entries aloud. We have also interviewed involved stakeholders for feedback and collected exploratory data on psychiatric symptoms from patients right after the intensive care stay.SettingVarious intensive care units in a single academic center.Main outcome measuresFeasibility was defined as intervention delivery on ≥80% of days following patient recruitment. Content analysis was performed on stakeholder interview responses. Questionnaire data were compared for patients who received real-time reading to the historical cohort who did not.ResultsOverall, 57% (17 of 30) of patients achieved the set feasibility threshold. Following protocol adjustment, we achieved 86% feasibility in the last subset of patients. Patients reported the intervention as comforting and appreciated the reorientation aspect. Nurses overwhelmingly liked the idea; most common concern was not knowing what to write. Some therapists were unsure whether reading entries aloud might overwhelm the patients. There were no significant differences in psychiatric symptoms when compared to the historic cohort.ConclusionWe encountered several implementation obstacles; once these were addressed, we achieved set feasibility target for the last group of patients. Reading diary entries aloud was welcomed by stakeholders. Designing a trial to assess efficacy of the intervention on psychiatric outcomes appears warranted.Implications for Clinical PracticeThere is no recommendation to change current practice as benefits of the intervention are unproven. |
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| Keywords: | ICU diaries Outcomes of critical illness Post intensive care syndrome |
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