Effectiveness of ICU Diaries: Improving “Distorted Memories” Encountered during ICU Admission  

作　　者：Tomohide Fukuda Tomoko Inoue Yoshiko Kinoshita Tamiko Yukawa 

机构地区：[1]Department of Critical and Invasive Palliative Care Nursing, Tokyo Medical and Dental University, Tokyo, Japan [2]Department of Nursing, NTT East Japan Kanto Hospital, Tokyo, Japan

出　　处：《Open Journal of Nursing》2015年第4期313-324,共12页护理学期刊（英文）

摘　　要：Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatments in the ICU. This study focused on the quantitative and qualitative effects of ICU diaries on distorted memories that patients encountered during their time in the ICU. Aim: To assess improving distorted memories by providing information during ICU admission to patients to relieve the acute stress symptoms after ICU discharge. Design and Methods: This nonrandomized controlled trial included patients aged ≥20 years who had received treatment for ≥3 days in the ICU. Using ICU memory tool, the Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder Scale (ASDS) approximately 1 week after ICU discharge, then HADS and ASDS prior to hospital discharge, the change in mean values were compared between two groups (control and intervention) using a Wilcoxon signed-rank test. The intervention group was surveyed prior to hospital discharge using semi-structured interviews, and descriptions were analyzed by the content analysis method of Krippendorff. Results: Twenty-three participants were included in the control group, and 17 in the intervention group. When comparing subjects with distorted memories between the groups, we found reduced values for HADS anxiety (7.1 ± 3.8 to 5.7 ± 2.7, p = 0.011), HADS depression (8.6 ± 5.0 to 7.2 ± 4.3, p = 0.003), and ASDS (46.9 ± 13.8 to 43.8 ± 11.4, p = 0.012) in the intervention group. Based on the narrations, patients wanted to investigate facts in the ICU diary while having someone help them to remember these events. Conclusion: Improving distorted memories during ICU admissions may relieve acute stress symptoms. In addition, these patients needed someone to investigate facts from the ICU admission.Background: It is said that after ICU discharge, 40% of patients suffer from acute stress symptoms, such as anxiety and depression, caused by “distorted memories” (memory loss and delusions) due to various treatments in the ICU. This study focused on the quantitative and qualitative effects of ICU diaries on distorted memories that patients encountered during their time in the ICU. Aim: To assess improving distorted memories by providing information during ICU admission to patients to relieve the acute stress symptoms after ICU discharge. Design and Methods: This nonrandomized controlled trial included patients aged ≥20 years who had received treatment for ≥3 days in the ICU. Using ICU memory tool, the Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder Scale (ASDS) approximately 1 week after ICU discharge, then HADS and ASDS prior to hospital discharge, the change in mean values were compared between two groups (control and intervention) using a Wilcoxon signed-rank test. The intervention group was surveyed prior to hospital discharge using semi-structured interviews, and descriptions were analyzed by the content analysis method of Krippendorff. Results: Twenty-three participants were included in the control group, and 17 in the intervention group. When comparing subjects with distorted memories between the groups, we found reduced values for HADS anxiety (7.1 ± 3.8 to 5.7 ± 2.7, p = 0.011), HADS depression (8.6 ± 5.0 to 7.2 ± 4.3, p = 0.003), and ASDS (46.9 ± 13.8 to 43.8 ± 11.4, p = 0.012) in the intervention group. Based on the narrations, patients wanted to investigate facts in the ICU diary while having someone help them to remember these events. Conclusion: Improving distorted memories during ICU admissions may relieve acute stress symptoms. In addition, these patients needed someone to investigate facts from the ICU admission.

关 键 词：AFTERCARE ACUTE Stress SYMPTOMS ICU DIARY Distorted Memories 

分 类 号：R73[医药卫生—肿瘤]