Thematic analysis of intensive care unit diaries kept by staff: insights for caring.
Alessandro Galazzi, Martina Bruno, Filippo Binda and 5 others
PMID 36731262WHAT IT FOUND
ICU staff diaries written during COVID-19 recorded daily care, communication, family contact, and farewells.
Nurses wrote most entries. Entries described first movements, hygiene, delirium, and end-of-life moments.
Key findings
01Four recurrent themes and ten subthemes were identified.
02Nurses wrote 428 of 518 entries (82.6%).
03Entries described first eating, movement, wheelchair transfer, body care, family contact, and farewell notes when patients died.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was conducted in two ICUs in one Italian hospital during the COVID-19 pandemic, so the diary content may not reflect usual ICU care. The analysis used staff-written diary entries, not patient or family interviews, so it does not show how patients or families experienced the diaries. Only 48 diaries and 518 entries were analysed, and the number and richness of entries varied between diaries. Family members did not write entries because visiting restrictions were in place. The analysis did not compare entries by writer job title or by time point during the pandemic. Planned follow-up was not possible, and families of deceased patients did not receive the diary.
Declared interests
This study was partially funded by the Italian Ministry of Health. The authors declared no known competing financial interests or personal relationships that could have appeared to influence the work.
The easy way to misread this
Do not read these themes as proof that ICU diaries reduce PTSD, anxiety, or depression. The study analysed what staff wrote in diaries. It did not test patient or family psychological outcomes.