Aloud real- time reading of intensive care unit diaries: A feasibility study.

Autor: Johnson KR; Department of Pulmonary and Critical Care, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: Johnson.Kimberly5@mayo.edu., Temeyer JP; Department of Nursing, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA., Schulte PJ; Department of Biostatistics, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA., Nydahl P; Department of Anesthesia and Critical Care, Arnold-Heller-Str. 3, University Hospital Schleswig-Holstein, Kiel 24105, Germany., Philbrick KL; Department of Psychiatry and Psychology, 200 First St SW, Mayo Clinic, Rochester, MN 55905, USA., Karnatovskaia LV; Department of Pulmonary and Critical Care, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Jazyk: angličtina
Zdroj: Intensive & critical care nursing [Intensive Crit Care Nurs] 2023 Jun; Vol. 76, pp. 103400. Date of Electronic Publication: 2023 Jan 25.
DOI: 10.1016/j.iccn.2023.103400
Abstrakt: Objectives: Memories 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 Methodology: Prospective 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.
Setting: Various intensive care units in a single academic center.
Main Outcome Measures: Feasibility 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.
Results: Overall, 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.
Conclusion: We 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 Practice: There is no recommendation to change current practice as benefits of the intervention are unproven.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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