A Thematic Analysis of Intensive Care Unit Diaries Content.
Maia S Kredentser, Kristin Reynolds, Nicole Marten and 3 others
PMID 40671371WHAT IT FOUND
Staff and families used ICU diaries to maintain connection with the patient, share medical updates, and cope with stress.
Nurses wrote nearly half the entries, often describing comfort care and personal details to humanize the unconscious patient.
Key findings
01Nurses wrote the majority of diary entries (49.5%), followed by family members (39.4%).
02Staff entries frequently focused on establishing the patient's personhood by noting non-medical care like braiding hair or acknowledging specific discomforts.
03Families used the diaries not just for patient updates but to express their own emotions, use humour, and cope with the helplessness of the ICU stay.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis included only 30 diaries, which limits generalizability. The diaries were written in a specific context (a pilot RCT) with 1:1 nursing ratios, which may not reflect current staffing levels or post-pandemic ICU environments. Family structure, socioeconomic variables, and the specific relationship of each writer to the patient were not tracked, so the context of who wrote what is limited. The diaries ended abruptly without a closing entry, which may affect the completeness of the narrative. The study is a secondary analysis of qualitative data, so it cannot establish efficacy or outcomes for patients or families.
Declared interests
Dr. Jitender Sareen is a consultant for UpToDate. No other conflicts of interest were reported. Funding came from the Manitoba Medical Service Foundation and the Canadian Institutes of Health Research.
The easy way to misread this
Do not interpret the frequent use of diaries for coping and connection as evidence that the intervention improves patient mental health outcomes. This study describes what was written in the diaries, not what happened to the patients as a result.