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Huang W, Gao Y, Zhou L, Xiao X, Xu H, Lu L, Deng J, Wu J. Effects of ICU diaries on psychological disorders and sleep quality in critically ill patients and their family members: A systematic review and meta-analysis. Sleep Med 2024; 122:84-91. [PMID: 39137664 DOI: 10.1016/j.sleep.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 07/22/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND The psychological health and sleep quality of intensive care unit (ICU) patients and their families have health implications, and greater attention should be devoted to developing effective interventions to address these concerns. Due to an increasing amount of evidence on ICU diary interventions, their comparative effectiveness should be evaluated. AIMS This systematic review and meta-analysis aimed to evaluate the effect of ICU diaries on psychological disorders and sleep quality in critically ill patients and on psychological disorders in their family members. METHODS The PubMed, Embase, Web of Science, Cochrane Library, China Biomedical Literature Database, China National Knowledge Network, Wanfang Database, and Weipu Chinese Journal databases were searched up to November 2023 to identify randomized controlled trials. We used the Cochrane Risk of Bias Tool for quality assessment, and we used Review Manager 5.4 software to conduct meta-analysis. RESULTS Eleven studies with a total of 1682 patients met the inclusion criteria. PATIENTS PTSD (7 studies, 1015 patients): OR 0.63 (95%CI 0.45-0.87), p = 0.005; Anxiety (6 studies, 546 patients): OR 0.52 (95%CI 0.22-1.27), p = 0.15; Depression (6 studies, 546 patients): OR 0.62 (95%CI 0.39-0.97), p = 0.04; sleep quality (2 studies, 203 patients): OR -3.97 (95%CI -7.71-0.23), p = 0.04. Family members: PTSD (2 studies, 652 patients): OR 0.81 (95%CI 0.37-1.79), p = 0.60; Anxiety (2 studies, 650 family members): OR 1.09 (95%CI 0.79-1.49), p = 0.62; Depression (2 studies, 650 patients): OR 1.03 (95%CI 0.71-1.50), p = 0.87. The pooled results of the meta-analysis showed that ICU diaries reduced the incidence of depression and post-traumatic stress disorder and improved sleep quality in patients, but had no significant effects on patients' anxiety status or family members' psychological disorders. Three of the included studies had a high quality, and the remaining eight studies had a moderate quality. CONCLUSIONS For patients, ICU diaries can improve their depression and post-traumatic stress disorder, improve sleep quality, but has no significant effect on anxiety; For family members, ICU diaries were not significant. Due to the existence of bias and the limited sample size, the results should be interpreted with caution. Researchers need to further elucidate the multidisciplinary collaborative process of diary-based treatment in ICUs and its impact on psychological disorders in family members. Furthermore, large-scale, multicentre, robust studies should be conducted in the future.
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Affiliation(s)
- Wenjie Huang
- Medical School of Nantong University, Nantong, 226001, China
| | - Yang Gao
- Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Lingjun Zhou
- Medical School of Nantong University, Nantong, 226001, China
| | - Xiaojuan Xiao
- Medical School of Nantong University, Nantong, 226001, China
| | - Hong Xu
- Medical School of Nantong University, Nantong, 226001, China
| | - Lizhou Lu
- Medical School of Nantong University, Nantong, 226001, China
| | - Jinhao Deng
- Medical School of Nantong University, Nantong, 226001, China
| | - Juan Wu
- Affiliated Hospital of Nantong University, Nantong, 226001, China.
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Riegel M, Buckley T, Randall S. Family's preferences for and experiences of writing practices in adult intensive care and its use in early bereavement: A descriptive qualitative study. Aust Crit Care 2024; 37:614-620. [PMID: 38360470 DOI: 10.1016/j.aucc.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Family partaking in writing practices, such as writing intensive care unit (ICU) patient diaries, personal diaries/journaling, social media, or instant messaging services, during ICU admission may allow the family to unintentionally participate in a form of expressive writing. These writing practices could provide structure for the family authors to explore emotions and manage significant life events, including death of a loved one. Limited studies have explored the family's postmortem experiences and perceived value of writing practices maintained during an ICU admission. OBJECTIVES The objective of this study was to explore the family member's preferences for and experiences of writing practices in the adult ICU and its use in early bereavement. METHODS descriptive qualitative design using inductive reflexive thematic analysis from a purposeful, convenience sample of 16 bereaved participants from a tertiary referral, adult ICU in Australia who discussed their experiences of and preferences in writing practices. Reporting adheres to the consolidated criteria for reporting qualitative research checklist. FINDINGS Six participants maintained writing practices during the ICU admission and 10 did not. Three themes were generated from the data: the decision to maintain writing practices was shaped by past behaviours and perceived utility; moments captured were influenced by the loved ones' clinical status and their ability to access the writing medium; and writing practices have limited utility as a memory making object in early bereavement. CONCLUSIONS Based on the generated findings, participants who did not maintain writing practices did not later regret this decision during early bereavement. Participants who did maintain writing practices predominately used a personal diary/journal that they carried with them. As the loved one approached death, the written entries became shorter, then ceased. Most of the written entries were not read during early bereavement, suggesting the writing practices' psychological value might have been predominately gained at the time of writing, rather than during early bereavement.
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Affiliation(s)
- Melissa Riegel
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Adult Intensive Care Unit, Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Thomas Buckley
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Broken Hill Department of Rural Health, University of Sydney, Australia
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Norton T, Chechel L, Sanchez C, Terterian G. A Qualitative Study to Explore the Nurses' Experience of Writing Caring Notes in Diaries for Extracorporeal Oxygenation Membrane (ECMO) Patients: Explore the nurse's experience. Crit Care Nurs Q 2024; 47:184-192. [PMID: 38860948 DOI: 10.1097/cnq.0000000000000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
The use of diaries is known to reduce post-intensive care syndrome in the intensive care unit (ICU) for survivors and families. Studies are needed to explore nurses' experience with diaries. Although the diaries are written for the patient, the diary entries may be helpful for the nurse as well. Research has shown that ICU diaries fill in significant memory gaps and aid in the resolution of delusional memories. However, there is a shortage of knowledge about the nurses' experience of writing caring notes in diaries. The purpose of this research was to explore the extracorporeal membrane oxygenation (ECMO) nurses' experience of writing caring notes in diaries during the patients' ICU stay. This is a descriptive phenomenological qualitative research study using semi-structured interviews. A one-on-one interview was performed, audiotaped, and transcribed. Three investigators analyzed the data for themes, subcategories, and indicators. A purposive sample of 15 specialty-trained ECMO nurses participated in the study. Three themes emerged from the study relating to the nurse, family, and patient, including positive and negative aspects of writing in the diary and barriers. The vast majority (88%) of 340 comments answered during the interviews were positive. Overall, nurses found the diaries to be beneficial to the nurse, family, and patient. Diary writing may help nurses get back to the core of why we do what they do. Understanding the nurses' experience may help to improve communication and family satisfaction while optimizing dairy programs.
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Affiliation(s)
- Tamara Norton
- Author Affiliation: Department of Cardiovascular Intensive Care (Norton); Department of Education Development and Research (Chechel); Department of Psychiatry, University of California San Diego Health, La Jolla, California (Sanchez); Department of Nursing, Cedars-Sinai Tarzana Medical Center, Tarzana, California (Terterian)
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Galazzi A, Bruno M, Binda F, Caddeo G, Chierichetti M, Roselli P, Grasselli G, Laquintana D. Thematic analysis of intensive care unit diaries kept by staff: insights for caring. Intensive Crit Care Nurs 2023; 76:103392. [PMID: 36731262 PMCID: PMC9870754 DOI: 10.1016/j.iccn.2023.103392] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/07/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To explore recurrent themes in diaries kept by intensive care unit (ICU) staff during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN Qualitative study. SETTING Two ICUs in a tertiary level hospital (Milan, Italy) from January to December 2021. METHODS ICU staff members wrote a digital diary while caring for adult patients hospitalized in the intensive care unit for >48 hours. A thematic analysis was performed. FINDINGS Diary entries described what happened and expressed emotions. Thematic analysis of 518 entries gleaned from 48 diaries identified four themes (plus ten subthemes): Presenting (Places and people; Diary project), Intensive Care Unit Stay (Clinical events; What the patient does; Patient support), Outside the Hospital (Family and topical events; The weather), Feelings and Thoughts (Encouragement and wishes; Farewell; Considerations). CONCLUSION The themes were similar to published findings. They offer insight into care in an intensive care unit during a pandemic, with scarce resources and no family visitors permitted, reflecting on the patient as a person and on daily care. The staff wrote farewell entries to dying patients even though no one would read them. IMPLICATIONS FOR CLINICAL PRACTICE The implementation of digital diaries kept by intensive care unit staff is feasible even during the COVID-19 pandemic. Diaries kept by staff can provide a tool to humanize critical care. Staff can improve their work by reflecting on diary records.
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Affiliation(s)
- Alessandro Galazzi
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Bruno
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Filippo Binda
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Corresponding author at: Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35 – 20122 Milan, Italy
| | - Giorgia Caddeo
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Chierichetti
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Roselli
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Grasselli
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Dario Laquintana
- Department of Healthcare Professions, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Hackenberger A. Intensive Care Unit Diaries: A Nurse-Led Program. Crit Care Nurse 2023; 43:20-30. [PMID: 36720281 DOI: 10.4037/ccn2023573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Following intensive care unit stays, patients with post-intensive care syndrome can experience mental health symptoms that impact quality of life. Intensive care unit diaries have been shown to improve outcomes for patients and their families. LOCAL PROBLEM Identification of limited support for high volumes of intensive care unit patients and families led to implementation of an intensive care unit diary program in a 24-bed adult medical-surgical intensive care unit. METHODS Patients requiring mechanical ventilation with an expected intensive care unit stay of more than 24 hours were provided intensive care unit diaries. Nursing staff and patients' families entered daily descriptive narratives of patients' progress during the stay. After intensive care unit discharge, patients and families reviewed the diaries to improve acceptance of their intensive care unit experience. Project evaluation included review of patient and family follow-up calls, a staff nurse feedback survey, and project champion debriefing sessions to gauge implementation success and feasibility. RESULTS Twenty diaries were completed and distributed to patients or families at intensive care unit discharge. Follow-up calls illustrated support and gratitude for diaries regardless of patient outcomes. Patients reported that diaries helped fill memory gaps between intensive care unit admission and discharge. Nurse surveys and project champion debriefings confirmed that completion of intensive care unit diary entries had minimal impact on workload, eased communication, and improved staff members' coping skills. CONCLUSION Successful intensive care unit diary program implementation has the potential to benefit patients, families, and nursing staff for little organizational cost.
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Affiliation(s)
- Abbygale Hackenberger
- Abbygale Hackenberger is an assistant teaching professor at the Pennsylvania State University Ross and Carol Nese College of Nursing, Hershey, Pennsylvania, and clinical education specialist at the University of Pittsburgh Medical Center, Central Pennsylvania
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Maagaard CA, Laerkner E. Writing a diary for ”you” —Intensive care nurses' narrative practices in diaries for patients: A qualitative study. Int J Nurs Stud 2022; 136:104363. [DOI: 10.1016/j.ijnurstu.2022.104363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/08/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
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Flahault C, Vioulac C, Fasse L, Bailly S, Timsit JF, Garrouste-Orgeas M. "A story with gaps": An interpretative phenomenological analysis of ICU survivors' experience. PLoS One 2022; 17:e0264310. [PMID: 35239692 PMCID: PMC8893654 DOI: 10.1371/journal.pone.0264310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
ICU survivors may experience various long-term sequelae, recognized as Post-Intensive Care Syndrome, that includes psychiatric symptoms: anxiety, depression, and post-traumatic stress disorders symptoms (PTSD). While it was hypothesized that an ICU diary could help patients after discharge, improving their hospitalization memories and quality of life, it is unclear whether it may reduce psychiatric disorders, in particular PTSD. We performed a qualitative exploration of survivors' subjective experience of their ICU stay, their representations, memories, meaning-making of their experience and use of their ICU diary. Five participants (ICU survivors, 3 men and 2 women, who received a diary) were included in this study. We conducted non-directive interviews 6 months after discharge. These interviews were transcribed and analyzed using Interpretative Phenomenological Analysis. Major recurring themes of discourse included: (1) The nightmare of the ICU experience: from an impression of vagueness to dispossession, (2) The positive image of health-care workers during intensive care, (3) The place of the relatives and health-care workers' writings in the diary: either a support or a barrier, (4) The difficult return back home, and daily life after intensive care. Participant's representation of their ICU experience seemed to reflect the meaning they had given it through their own reflections and that of health-care workers in the diary. For some participant, the diary was associated to the pain and strangeness of the ICU experience; therefore, their recovery required them to take some distance with it. The ICU diary allowed participants to construct their illness narratives, and to become aware of the presence and support of health-care workers. The diary was also perceived as the witness of a period they wished to forget. Trial registration: NCT02519725.
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Affiliation(s)
- Cécile Flahault
- Laboratory of Psychopathology and Health Processes, Paris University, Paris, France
| | - Christel Vioulac
- Laboratory of Psychopathology and Health Processes, Paris University, Paris, France
| | - Léonor Fasse
- Laboratory of Psychopathology and Health Processes, Paris University, Paris, France
| | - Sébastien Bailly
- Grenoble Alpes University, INSERM, CHU Grenoble Alpes, HP2, Grenoble, France
| | - Jean-François Timsit
- Paris University, IAME, INSERM, Paris, France.,Department of Biostatistics, Outcomerea, Paris, France.,Medical ICU, Bichat University Hospital, Paris, France
| | - Maité Garrouste-Orgeas
- Paris University, IAME, INSERM, Paris, France.,Medical Unit, French British Hospital, Levallois-Perret, France.,Palliative Care Unit, Fondation Diaconesses Reuilly, Rueil Malmaison, France
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Abstract
As the progress of critical care medicine has improved the survival rate of critically ill patients, comorbidities and long-term health care have attracted people's attention. The terms "post-intensive care syndrome" (PICS) and "PICS-family" (PICS-F) have been used in non-neurocritical care populations, which are characterized by the cognitive, psychiatric, and physical sequelae associated with intensive care hospitalization of survivors and their families. An intensive care unit (ICU) diary authored by the patient's family members may alleviate the psychological distress of the patient and his or her family. This quality improvement project focused on the development and implementation of the pediatric intensive care unit (PICU) diary in the pediatric critical care setting. The project aims to evaluate the feasibility and the potential efficacy of the PICU diary, measured through parental acceptance and satisfaction. Seventeen families of critically ill children admitted to the PICU received the PICU diary during the implementation period. Twenty-four parents completed the weekly follow-up, and 15 subsequently completed the diary entry evaluation. The use of the diary in the PICU setting is feasible and considered beneficial by families of critically ill children.
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Multimodal biometric monitoring technologies drive the development of clinical assessments in the home environment. Maturitas 2021; 151:41-47. [PMID: 34446278 DOI: 10.1016/j.maturitas.2021.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 01/23/2023]
Abstract
Biometric monitoring technologies (BioMeTs) have attracted the attention of the health care community because of their user-friendly form factor and multi-sensor data-collection capabilities. The potential benefits of remote monitoring for collecting comprehensive, longitudinal, and contextual datasets span therapeutic areas, and both chronic and acute disease settings. Importantly, multimodal BioMeTs unlock the ability to generate rich contextual data to augment digital measures. Currently, the availability of devices is no longer the main factor limiting adoption but rather the ability to integrate fit-for-purpose BioMeTs reliably and safely into clinical care. We provide a critical review of the state of art for multimodal BioMeTs in clinical care and identify three unmet clinical needs: 1) expand the abilities of existing ambulatory unimodal BioMeTs; 2) adapt standardized clinical test protocols ("spot checks'') for use under free living conditions; and 3) develop novel applications to manage rehabilitation and chronic diseases. As the field is still in an early and quickly evolving state, we make practical recommendations: 1) to select appropriate BioMeTs; 2) to develop composite digital measures; and 3) to design interoperable software to ingest, process, delegate, and visualize the data when deploying novel clinical applications. Multimodal BioMeTs will drive the evolution from in-clinic assessments to at-home data collection with a focus on prevention, personalization, and long-term outcomes by empowering health care providers with knowledge, delivering convenience, and an improved standard of care to patients.
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Sansone V, Cancani F, Gagliardi C, Satta T, Cecchetti C, de Ranieri C, Di Nardo M, Rossi A, Dall'Oglio I, Alvaro R, Tiozzo E, Gawronski O. Narrative diaries in the paediatric intensive care unit: A thematic analysis. Nurs Crit Care 2021; 27:45-54. [PMID: 34256419 DOI: 10.1111/nicc.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The paediatric intensive care unit (PICU) diary is a shared tool, kept at the patient bedside, written by relatives and health care providers. There is little evidence about its feasibility and how it supports the families of children admitted to the PICU. Currently, there is no evidence about how the PICU diary is used and what we can learn from it. AIM To explore the contents of narrative PICU diaries in an Italian PICU. STUDY DESIGN Qualitative study of PICU diaries conducted with a narrative research approach. METHODS Children sedated and mechanically ventilated for >48 hours were enrolled in a six-bed Italian PICU of a tertiary care paediatric hospital. During the child's PICU admission, caregivers, relatives, friends, and health care providers were invited to report events, thoughts, and messages, and attach drawings/pictures for the child in the PICU diary. A thematic analysis of the PICU diary contents was performed. RESULTS Thirteen PICU diaries were completed between August and December 2020, mainly by parents (n = 95; 45%) and health care providers (n = 52; 25%). Three main themes emerged: "Social and spiritual support," "Caregiver's emotions, feelings and distress," and "PICU life." Diaries offer insight into caregivers' emotions, social support, clinical activities, and interactions with health care providers, and on progression towards recovery. CONCLUSION PICU diaries are valuable in facilitating family-centred care by providing a space for the written account of the child's admission by parents, other visitors, and health care providers. RELEVANCE TO CLINICAL PRACTICE PICU diaries support the relationship and the communication between the family and the team; they provide an informal account of the emotions and needs of parents that has the potential to improve mutual understanding and family-centred care. Social support and spiritual support are key elements reported by parents for coping with their child's PICU admission.
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Affiliation(s)
- Vincenza Sansone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Federica Cancani
- Pediatric Intensive Care Unit, Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Chiara Gagliardi
- Pediatric Intensive Care Unit, Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Tiziana Satta
- Pediatric Intensive Care Unit, Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Corrado Cecchetti
- Pediatric Intensive Care Unit, Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angela Rossi
- Clinical Psychology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Immacolata Dall'Oglio
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuing Education and Research Unit, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Vogel G, Joelsson-Alm E, Forinder U, Svensen C, Sandgren A. Stabilizing life: A grounded theory of surviving critical illness. Intensive Crit Care Nurs 2021; 67:103096. [PMID: 34244030 DOI: 10.1016/j.iccn.2021.103096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The experience of critical illness among patients is both complex and multifaceted. It can make patients vulnerable to long-term consequences such as impairment in cognition, mental health and physical functional ability which affects health related quality of life. This study aims to explore patients' patterns of behaviour during the process from becoming critical ill to recovery at home. DESIGN We used a classic grounded theory methodology to explore the main concern for intensive care patients. Thirteen participants were interviewed and seven different participants were observed. SETTING Three general intensive care units in Sweden, consisting of a university hospital, a county hospital and a district hospital. FINDINGS The theory Stabilizing life explains how patients' main concern, being out of control, can be resolved. This theory involves two processes, recapturing life and recoding life, and one underlying strategy, emotional balancing that is used during the whole process. CONCLUSION The process from becoming critically ill until recovery home is perceived as a constant fight in actions and mind to achieve control and stabilize life. This theory can form the basis for further qualitative and quantitative research about interventions that promotes wellbeing during the whole process.
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Affiliation(s)
- Gisela Vogel
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Ulla Forinder
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden.
| | - Christer Svensen
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Universitetsplatsen 1, 352 52 Växjö, Sweden.
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Exploring Patients' Perceptions on ICU Diaries: A Systematic Review and Qualitative Data Synthesis. Crit Care Med 2021; 49:e707-e718. [PMID: 33861546 DOI: 10.1097/ccm.0000000000005019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aims to summarize the current qualitative evidence on patients' experiences of reading the ICU diaries. DATA SOURCES We searched the online databases PubMed, Ovid, EMBASE, and EBSCO host from inception to July 2020. STUDY SELECTION All studies that presented any qualitative findings regarding patients' experiences of reading an ICU diary were included. DATA EXTRACTION Study design, location, publication year, data collection method, and mode, all qualitative themes identified and reported, and participant quotations, when appropriate. We also extracted data regarding the diary structure, when available. A thematic synthesis approach was used to analyze and synthesize qualitative data. DATA SYNTHESIS Seventeen studies were analyzed. Most patients reported positive experiences with the ICU diary, such as understanding what they survived during critical illness, better understanding the process of recovery, gaining coherence of nightmares and delusional memories, realizing the importance of the presence of family and loved ones during ICU stay, and humanizing healthcare professionals that helped them survive critical illness. Patients also reported which components of the diary were important for their recovery, such as the presence of photographs and reading the diary with a healthcare professional, allowing the improvement of the concept of the ICU diary. CONCLUSION This qualitative synthesis shows that patients recommend having an ICU diary, enlightening benefits such as better coping with the slow recovery from critical illness, strengthening family ties, and humanizing the ICU staff. It also identifies characteristics of the diary valued by the patients, in order to standardize the ICU diary according to their perspectives, and allowing future comparability between randomized controlled trials.
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Drumright K, Jones AC, Gervasio R, Hill C, Russell M, Boehm LM. Implementation of an Intensive Care Unit Diary Program at a Veterans Affairs Hospital. J Nurs Care Qual 2021; 36:155-161. [PMID: 32826699 PMCID: PMC7889738 DOI: 10.1097/ncq.0000000000000510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Intensive care unit (ICU) diaries are recommended to address psychological sequelae following critical illness. Diaries are correlated with reduced prevalence of posttraumatic stress disorder in survivors of critical illness and their families. LOCAL PROBLEM Our ICU was not adequately meeting the psychological needs of patients and families. METHODS We established an interprofessional team to implement an ICU diary program in partnership with implementation of the ABCDEF (Assess, prevent, and manage pain; Both awakening and breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment) bundle and peer support programs. Staff knowledge and perception of ICU diaries were obtained. INTERVENTIONS Diaries were initiated for patients at high risk for post-intensive care syndrome, and entries by all ICU staff and family members/visitors were encouraged. RESULTS A total of 75 diaries were initiated between January 2017 and January 2019. The ICU diaries have been received positively by patients, family members, and staff. CONCLUSIONS The ICU diary is a cost-effective and efficient intervention to help patients and family members cope with the burden of critical illness.
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Affiliation(s)
- Kelly Drumright
- TN Valley Healthcare System, Nashville Veterans Affairs Hospital, Nashville, TN, USA
| | - Abigail C. Jones
- Vanderbilt University School of Nursing, Nashville, TN, USA
- Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, TN, USA
| | - Ralph Gervasio
- TN Valley Healthcare System, Nashville Veterans Affairs Hospital, Nashville, TN, USA
| | - Christopher Hill
- TN Valley Healthcare System, Nashville Veterans Affairs Hospital, Nashville, TN, USA
| | - Margaret Russell
- TN Valley Healthcare System, Nashville Veterans Affairs Hospital, Nashville, TN, USA
| | - Leanne M. Boehm
- TN Valley Healthcare System, Nashville Veterans Affairs Hospital, Nashville, TN, USA
- Vanderbilt University School of Nursing, Nashville, TN, USA
- Critical Illness, Brain dysfunction, and Survivorship Center at Vanderbilt, Nashville, TN, USA
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Schofield R, Dibb B, Coles-Gale R, Jones CJ. The experience of relatives using intensive care diaries: A systematic review and qualitative synthesis. Int J Nurs Stud 2021; 119:103927. [PMID: 33905992 DOI: 10.1016/j.ijnurstu.2021.103927] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/04/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Intensive care patient diaries written by staff and/or relatives are widely used in intensive care units (ICUs) across the world. Although the original aim of the diaries was to support patients in their recovery from ICU, a more recent focus of the literature has been the potential benefit of the diaries to the relatives of patients. Meta-analyzes of quantitative studies looking at the impact on the psychological wellbeing of relatives have not consistently found an effect of the diaries, even though qualitative studies suggest that relatives find the diaries to be a useful coping strategy. OBJECTIVES To evaluate and synthesise qualitative studies looking at the experience of relatives writing in ICU diaries. DESIGN A systematic review and qualitative synthesis. DATA SOURCES A structured search using CINAHL, MEDLINE, PsycInfo, Cochrane Central Register of Controlled Trials (CENTRAL), PTSDHubs and Published International Literature Web of Science Conference Proceedings Citation Index - Science and Social Science and Humanities was conducted. REVIEW METHODS All studies published at any time that included qualitative data (including mixed methods studies) about the perceptions of relatives using ICU patient diaries were included. Themes and narrative statements were extracted from included articles and synthesised. Articles were quality assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist and Mixed Methods Appraisal Tool (MMAT). RESULTS Sixteen studies were included in the review, thirteen qualitative and three mixed methods articles. The themes identified were: 1. Coping (subthemes: 1.1. Emotion-Focused Coping and 1.2. Problem-Focused Coping) 2. Connection (subthemes: 2.1 Method of Communication and 2.2 Developing and maintaining relationships) 3. Developing a Narrative (subthemes 3.1 Understanding 3.2 Shaping the story 3.3 Remembering). CONCLUSIONS Relatives use the diaries in a variety of ways including as a means of coping, a way of staying connected, as a tool to understand and develop a narrative about the experience. These findings link the use of ICU diaries with literature on written emotional exposure, post-traumatic growth and meaning making. The relationship between a relative's use of the ICU diary, coping strategies and/or post-traumatic growth could be a focus for future quantitative trials. PROSPERO protocol number CRD42020165869.
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Affiliation(s)
- Rachel Schofield
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK.
| | - Bridget Dibb
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK
| | - Rebecca Coles-Gale
- East Sussex Healthcare NHS Trust, St. Anne's House, 729 The Ridge, St. Leonards-on-Sea, East Sussex TN37 7PT, UK
| | - Christina J Jones
- University of Surrey, Stag Hill, University Campus, Guildford GU2 7XH, UK
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15
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Affiliation(s)
- Christina Jones
- Research Manager ICU steps and Visiting Research Fellow, University of Plymouth, United Kingdom
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16
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Sun X, Huang D, Zeng F, Ye Q, Xiao H, Lv D, Zhao P, Cui X. Effect of intensive care unit diary on incidence of posttraumatic stress disorder, anxiety, and depression of adult intensive care unit survivors: A systematic review and meta-analysis. J Adv Nurs 2021; 77:2929-2941. [PMID: 33483993 DOI: 10.1111/jan.14706] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/11/2023]
Abstract
AIM To systematically evaluate the effect of intensive care unit diary psychotherapy on the incidence of posttraumatic stress disorder, anxiety, and depression after discharge from intensive care unit. BACKGROUND Many studies have reported the potential advantages and risks of intensive care unit diary psychotherapy in adult patients discharged from intensive care unit, but the results are divergent. DESIGN Systematic review and meta-analysis of prospective randomized controlled or case-controlled studies. DATA SOURCE Databases such as Cochran Library, Pubmed, Embase, CINAHL, and ProQuest databases, China national knowledge infrastructure (CNKI) were searched for literatures published from January 2000-March 2020. REVIEW METHODS We use the Cochrane Risk of Bias Tool for quality assessment and audit manager 5.3 software for meta-analysis. The main result is the incidence of posttraumatic stress disorder, anxiety, and depression. RESULTS Ten studies meeting the inclusion criteria were identified, including eight randomized controlled studies and two case-controlled studies, with a total of 1,210 patients. The pooled results of this meta-analysis indicated that the intensive care unit diary could reduce the incidence of posttraumatic stress disorder, anxiety, and depression. CONCLUSION This study showed that an intensive care unit diary could improve the psychological symptoms of adult intensive care unit patients after discharge. However, due to limitations such as publication bias and case sample size, the results should be carefully considered. Researchers need to further clarify the multidisciplinary collaborative process of intensive care unit diary therapy, the real beneficiaries, and its impact on family members' psychological status by conducting large, robust studies in the future. IMPACT This study's findings suggest that medical staff need to re-examine the role of intensive care unit diary therapy, its standardized implementation and provide effective intervention for reducing psychological stress-related symptoms of intensive care unit patients after discharge.
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Affiliation(s)
- Xihui Sun
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Debin Huang
- Department of Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Fan Zeng
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Qiao Ye
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
| | - Huineng Xiao
- Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Nanchong City, China
| | - Deping Lv
- Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Nanchong City, China
| | - Ping Zhao
- Department of Critical Care Medicine, Chongqing Bishan District People's Hospital (Bishan Hospital, First Affiliated Hospital of Chongqing Medical University), Bishan, China
| | - Xueting Cui
- Department of Critical Care Medicine, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China
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Intensive Care Unit Patient Diaries: A Review Evaluating Implementation and Feasibility. Crit Care Nurs Clin North Am 2021; 32:313-326. [PMID: 32402324 DOI: 10.1016/j.cnc.2020.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Post-intensive care syndrome is a detrimental cluster of symptoms that can have a negative impact on life after discharge from the intensive care unit (ICU). The use of patient diaries while hospitalized in the ICU has been reported to help survivors and families create memories and fill in gaps from their hospitalization. A review of the literature revealed that patient selection, diary content, family involvement, and staff perceptions are essential to the implementation of a diary program. Understanding the importance and impact diaries can have on survivors increases compliance and sustainability of this program.
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Original Research: Exploring the Effects of a Nurse-Initiated Diary Intervention on Post-Critical Care Posttraumatic Stress Disorder. Am J Nurs 2020; 120:24-33. [PMID: 32332363 DOI: 10.1097/01.naj.0000662804.81454.66] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Critical illness survivors may develop posttraumatic stress disorder (PTSD) following critical illness and hospitalization. Left untreated, PTSD may result in poor health outcomes. PURPOSE This study sought to examine the effects of a nurse-initiated diary intervention on PTSD development and symptom severity in critical illness survivors with varying levels of mentation. METHODS The study used a pretest-posttest control group design. Patients who were hospitalized in a critical care unit for more than 24 hours were recruited at a single medical center with two such units. All participants completed a pretest on day 2 of critical care hospitalization; the intervention group participants also received a diary. All participants received a posttest one month after critical care discharge. The variables examined were PTSD severity and symptoms of avoidance, intrusion, and hyperarousal. Variables were measured using the Impact of Event Scale-Revised. Diaries were written by the patient, visitors, and interdisciplinary team members, and kept by the patient. RESULTS A total of 134 participants completed the study. The intervention group participants experienced significantly fewer PTSD symptoms than the control group participants. PTSD was found to be of concern in 35 (26%) of all participants: five in the intervention group and 30 in the control group. CONCLUSIONS For critical illness survivors, a collaborative diary-writing intervention during hospitalization and after discharge can mitigate post-critical care PTSD. Participants who received diaries had a lower incidence of PTSD symptoms than controls; and at follow-up, they indicated that the diary intervention was worthwhile. We recommend the use of collaborative diary writing to help critical illness survivors in working through their experiences.
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Abstract
Art in nursing is present in various forms and there is ample literature exploring creativity, including journaling for clinicians, intensive care unit diaries for patients and providers, and music therapy for patients. Illness narratives, depictions of the sick, or the effects of disease are commonly represented in media. This article highlights how creativity and various mediums of artistic expressions may can be used as a self-care practice and aid in boosting empathy in health care providers. Theories on empathy are presented as well as selected representations of nursing as creative expressions and the importance of promoting creativity and empathy.
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Affiliation(s)
- Susan Bartos
- Egan School of Nursing, Fairfield University, 1073 North Benson Road, Fairfield, CT 06824, USA.
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20
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Bagnasco A, Aleo G, Timmins F, Catania G, Zanini M, Brady AM, Sasso L. The potential contribution of mixed-method research to critical care nursing. Nurs Crit Care 2020; 24:113-114. [PMID: 31074551 DOI: 10.1111/nicc.12431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Annamaria Bagnasco
- Associate Professor of Nursing, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Research Fellow and Lecturer, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- Associate Professor of Nursing, Director of Post Graduate Teaching and Learning, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gianluca Catania
- Assistant Professor and Researcher, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Assistant Professor and Researcher, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Anne-Marie Brady
- Professor of Chronic Illness, Head of School, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Loredana Sasso
- Full Professor of Nursing, Department of Health Sciences, University of Genoa, Genoa, Italy
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21
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How well do we transition patients from ICU to the ward? Let our patients tell us. Intensive Crit Care Nurs 2020; 58:102825. [PMID: 32147293 DOI: 10.1016/j.iccn.2020.102825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Eaton TL, McPeake J, Rogan J, Johnson A, Boehm LM. Caring for Survivors of Critical Illness: Current Practices and the Role of the Nurse in Intensive Care Unit Aftercare. Am J Crit Care 2019; 28:481-485. [PMID: 31676524 DOI: 10.4037/ajcc2019885] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Tammy L Eaton
- Tammy L. Eaton is cofounder and lead advanced practice provider for the Critical Illness Recovery Center (CIRC) post-ICU clinic and codirector of the ICU Survivor and Family Peer Support and ICU journal programs at UPMC Mercy, a PhD student at the University of Pittsburgh School of Nursing, and an inpatient palliative care nurse practitioner, Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, Pennsylvania. Joanne McPeake is a nurse consultant in clinical research and innovation in NHS Greater Glasgow and Clyde and a senior clinical lecturer in the School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland. Julie Rogan is a clinical nurse specialist focused on implementation of ICU survivorship activities, including ICU diary and peer support programs. She is currently enrolled in the Doctor of Nursing Practice program at the University of Pennsylvania, Philadelphia. Annie Johnson is cochair of the Society of Critical Care Medicine (SCCM) Thrive Peer Support Collaborative and a bedside critical care nurse practitioner at Mayo Clinic in Rochester, Minnesota. Annie also coleads the Mayo Clinic ICU Recovery Program. Leanne Boehm is an assistant professor at Vanderbilt University and is interested in implementation of evidence-based practice and organizational factors that influence interprofessional efforts in the acute care setting. All authors are founding members of the Critical and Acute Illness Recovery Organization (CAIRO), an international consortium of active clinical programs working to advance the practice and science of critical and acute illness recovery.
| | - Joanne McPeake
- Tammy L. Eaton is cofounder and lead advanced practice provider for the Critical Illness Recovery Center (CIRC) post-ICU clinic and codirector of the ICU Survivor and Family Peer Support and ICU journal programs at UPMC Mercy, a PhD student at the University of Pittsburgh School of Nursing, and an inpatient palliative care nurse practitioner, Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, Pennsylvania. Joanne McPeake is a nurse consultant in clinical research and innovation in NHS Greater Glasgow and Clyde and a senior clinical lecturer in the School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland. Julie Rogan is a clinical nurse specialist focused on implementation of ICU survivorship activities, including ICU diary and peer support programs. She is currently enrolled in the Doctor of Nursing Practice program at the University of Pennsylvania, Philadelphia. Annie Johnson is cochair of the Society of Critical Care Medicine (SCCM) Thrive Peer Support Collaborative and a bedside critical care nurse practitioner at Mayo Clinic in Rochester, Minnesota. Annie also coleads the Mayo Clinic ICU Recovery Program. Leanne Boehm is an assistant professor at Vanderbilt University and is interested in implementation of evidence-based practice and organizational factors that influence interprofessional efforts in the acute care setting. All authors are founding members of the Critical and Acute Illness Recovery Organization (CAIRO), an international consortium of active clinical programs working to advance the practice and science of critical and acute illness recovery
| | - Julie Rogan
- Tammy L. Eaton is cofounder and lead advanced practice provider for the Critical Illness Recovery Center (CIRC) post-ICU clinic and codirector of the ICU Survivor and Family Peer Support and ICU journal programs at UPMC Mercy, a PhD student at the University of Pittsburgh School of Nursing, and an inpatient palliative care nurse practitioner, Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, Pennsylvania. Joanne McPeake is a nurse consultant in clinical research and innovation in NHS Greater Glasgow and Clyde and a senior clinical lecturer in the School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland. Julie Rogan is a clinical nurse specialist focused on implementation of ICU survivorship activities, including ICU diary and peer support programs. She is currently enrolled in the Doctor of Nursing Practice program at the University of Pennsylvania, Philadelphia. Annie Johnson is cochair of the Society of Critical Care Medicine (SCCM) Thrive Peer Support Collaborative and a bedside critical care nurse practitioner at Mayo Clinic in Rochester, Minnesota. Annie also coleads the Mayo Clinic ICU Recovery Program. Leanne Boehm is an assistant professor at Vanderbilt University and is interested in implementation of evidence-based practice and organizational factors that influence interprofessional efforts in the acute care setting. All authors are founding members of the Critical and Acute Illness Recovery Organization (CAIRO), an international consortium of active clinical programs working to advance the practice and science of critical and acute illness recovery
| | - Annie Johnson
- Tammy L. Eaton is cofounder and lead advanced practice provider for the Critical Illness Recovery Center (CIRC) post-ICU clinic and codirector of the ICU Survivor and Family Peer Support and ICU journal programs at UPMC Mercy, a PhD student at the University of Pittsburgh School of Nursing, and an inpatient palliative care nurse practitioner, Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, Pennsylvania. Joanne McPeake is a nurse consultant in clinical research and innovation in NHS Greater Glasgow and Clyde and a senior clinical lecturer in the School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland. Julie Rogan is a clinical nurse specialist focused on implementation of ICU survivorship activities, including ICU diary and peer support programs. She is currently enrolled in the Doctor of Nursing Practice program at the University of Pennsylvania, Philadelphia. Annie Johnson is cochair of the Society of Critical Care Medicine (SCCM) Thrive Peer Support Collaborative and a bedside critical care nurse practitioner at Mayo Clinic in Rochester, Minnesota. Annie also coleads the Mayo Clinic ICU Recovery Program. Leanne Boehm is an assistant professor at Vanderbilt University and is interested in implementation of evidence-based practice and organizational factors that influence interprofessional efforts in the acute care setting. All authors are founding members of the Critical and Acute Illness Recovery Organization (CAIRO), an international consortium of active clinical programs working to advance the practice and science of critical and acute illness recovery
| | - Leanne M Boehm
- Tammy L. Eaton is cofounder and lead advanced practice provider for the Critical Illness Recovery Center (CIRC) post-ICU clinic and codirector of the ICU Survivor and Family Peer Support and ICU journal programs at UPMC Mercy, a PhD student at the University of Pittsburgh School of Nursing, and an inpatient palliative care nurse practitioner, Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, Pennsylvania. Joanne McPeake is a nurse consultant in clinical research and innovation in NHS Greater Glasgow and Clyde and a senior clinical lecturer in the School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland. Julie Rogan is a clinical nurse specialist focused on implementation of ICU survivorship activities, including ICU diary and peer support programs. She is currently enrolled in the Doctor of Nursing Practice program at the University of Pennsylvania, Philadelphia. Annie Johnson is cochair of the Society of Critical Care Medicine (SCCM) Thrive Peer Support Collaborative and a bedside critical care nurse practitioner at Mayo Clinic in Rochester, Minnesota. Annie also coleads the Mayo Clinic ICU Recovery Program. Leanne Boehm is an assistant professor at Vanderbilt University and is interested in implementation of evidence-based practice and organizational factors that influence interprofessional efforts in the acute care setting. All authors are founding members of the Critical and Acute Illness Recovery Organization (CAIRO), an international consortium of active clinical programs working to advance the practice and science of critical and acute illness recovery
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Kemp HI, Laycock H, Costello A, Brett SJ. Chronic pain in critical care survivors: a narrative review. Br J Anaesth 2019; 123:e372-e384. [PMID: 31126622 DOI: 10.1016/j.bja.2019.03.025] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 01/28/2023] Open
Abstract
Chronic pain is an important problem after critical care admission. Estimates of the prevalence of chronic pain in the year after discharge range from 14% to 77% depending on the type of cohort, the tool used to measure pain, and the time point when pain was assessed. The majority of data available come from studies using health-related quality of life tools, although some have included pain-specific tools. Nociceptive, neuropathic, and nociplastic pain can occur in critical care survivors, but limited information about the aetiology, body site, and temporal trajectory of pain is currently available. Older age, pre-existing pain, and medical co-morbidity have been associated with pain after critical care admission. No trials were identified of interventions to target chronic pain in survivors specifically. Larger studies, using pain-specific tools, over an extended follow-up period are required to confirm the prevalence, identify risk factors, explore any association between acute and chronic pain in this setting, determine the underlying pathological mechanisms, and inform the development of future analgesic interventions.
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Affiliation(s)
- Harriet I Kemp
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Helen Laycock
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Stephen J Brett
- Department of Surgery and Cancer, Imperial College London, London, UK
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