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The use and application of intensive care unit diaries: an instrumental multiple case study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Elizabeth Hanson, Lennart Magnusson, Ingrid Wåhlin)ORCID iD: 0000-0002-9247-4339
2019 (English)Manuscript (preprint) (Other academic)
Place, publisher, year, edition, pages
2019.
Keywords [en]
Case study research, Diaries, Experiences, Family members, ICU, Nursing staff
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-89002OAI: oai:DiVA.org:lnu-89002DiVA, id: diva2:1349266
Available from: 2019-09-07 Created: 2019-09-07 Last updated: 2019-09-25
In thesis
1. Intensivvårdsdagbok i Sverige: betydelse och tillämpning
Open this publication in new window or tab >>Intensivvårdsdagbok i Sverige: betydelse och tillämpning
2019 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis was to explore how the Intensive Care Unit (ICU) diary was experienced by family members, family members of non-survivors and nursing staff in the ICU setting, thereby contributing to the development of national clinical practice guidelines regarding the structure, content and use of the ICU diary.

Methods:  A qualitative design was employed for all four studies:  a hermeneutic approach was adopted in studies I and II, whilst a qualitative descriptive design with the use of focus groups interviews was chosen in study III. An Instrumental Multiple Case Study design was carried out in study IV.

Main Findings: The diary symbolised the maintenance of relationships with the patients and was a substitute for the usual opportunities for communication. The diary was instrumental in meeting the needs of the majority of participant family members. The diary provided the means to be present at the patient’s bedside, to feel involved in caregiving, to maintain hope and to relay relevant information. If the critically ill family member did not survive the stay in the ICU, the diary acted as a form of bereavement support by processing the death of the patient. Nevertheless, some family members found the diary too public an arena to write in as the diary entries indicated visiting patterns which in turn provoke feelings of guilt when the visits were infrequent. Further, not knowing what to write was another source of pressure.

Nursing staff experienced that writing diaries often felt meaningful and led to an increased motivation and engagement in patient care and family support. They expressed that they felt they did something good for the patient and family members. Thus, the diary can be seen as a way to promote person-centred care, where family members were offered to participate in the care. However, in the absence of guidelines or clear guidelines about the use of an ICU diary, then not many patients actually received a diary.

Conclusions: Practice guidelines concerning ICU diaries would help to ensure the more widespread and consistent use of diaries for all ICU patients. As family members may benefit from the diary, even if the patient may not always be able to do so. The ICU diary can be seen as a tool to help promote person-centred care by directly involving family members and providing a human touch, thus helping to counterbalance the highly technical physical environment of ICU.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2019. p. 75
Series
Linnaeus University Dissertations ; 358
Keywords
case study research, diaries, experiences, family members, hermeneutics, ICU, nursing staff, thematic analysis
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-89006 (URN)978-91-88898-80-7 (ISBN)978-91-88898-81-4 (ISBN)
Public defence
2019-09-13, N2007, Västergård, Kalmar, Smålandsgatan 26, Kalmar, 10:00 (Swedish)
Opponent
Available from: 2019-09-09 Created: 2019-09-07 Last updated: 2019-10-04Bibliographically approved

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Johansson, Maria

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CiteExportLink to record
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Citation style
  • apa
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  • modern-language-association-8th-edition
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Output format
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