The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)

Anne Højager Nielsen; Sanne Angel; Ingrid Egerod; Trine Højfeldt Lund; Marianne Renberg; Torben Bæk Hansen

doi:10.1016/j.aucc.2019.01.004

The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)

Anne Højager Nielsen^*, Sanne Angel, Ingrid Egerod, Trine Højfeldt Lund, Marianne Renberg, Torben Bæk Hansen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial. Objectives: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient. Methods: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge. Results: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life. Conclusion: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.

Original language	English
Journal	Australian Critical Care
Volume	33
Issue	2
Pages (from-to)	123-129
Number of pages	7
ISSN	1036-7314
DOIs	https://doi.org/10.1016/j.aucc.2019.01.004
Publication status	Published - Mar 2020

Keywords

Critical care
Critical care nursing
Family nursing
Intensive care diaries
Posttraumatic
Stress disorders

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10.1016/j.aucc.2019.01.004

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@article{dc2036c609164b3c863784a12cfdc332,

title = "The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)",

abstract = "Background: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial. Objectives: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient. Methods: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge. Results: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life. Conclusion: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.",

keywords = "Critical care, Critical care nursing, Family nursing, Intensive care diaries, Posttraumatic, Stress disorders",

author = "Nielsen, {Anne H{\o}jager} and Sanne Angel and Ingrid Egerod and Lund, {Trine H{\o}jfeldt} and Marianne Renberg and Hansen, {Torben B{\ae}k}",

year = "2020",

month = mar,

doi = "10.1016/j.aucc.2019.01.004",

language = "English",

volume = "33",

pages = "123--129",

journal = "Australian Critical Care",

issn = "1036-7314",

publisher = "Elsevier",

number = "2",

}

The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study). / Nielsen, Anne Højager ; Angel, Sanne; Egerod, Ingrid et al.
In: Australian Critical Care, Vol. 33, No. 2, 03.2020, p. 123-129.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives

T2 - A randomised controlled trial (DRIP-study)

AU - Nielsen, Anne Højager

AU - Angel, Sanne

AU - Egerod, Ingrid

AU - Lund, Trine Højfeldt

AU - Renberg, Marianne

AU - Hansen, Torben Bæk

PY - 2020/3

Y1 - 2020/3

N2 - Background: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial. Objectives: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient. Methods: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge. Results: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life. Conclusion: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.

AB - Background: Critical illness and mechanical ventilation may cause patients and their relatives to experience symptoms of posttraumatic stress, anxiety, and depression due to fragmentation of memories of their intensive care unit (ICU) stay. Intensive care diaries authored by nurses may help patients and relatives process the experience and reduce psychological problems after hospital discharge; however, as patients particularly appreciate diary entries made by their relatives, involving relatives in authoring the diary could prove beneficial. Objectives: The objective of this study was to explore the effect of a diary authored by a close relative for a critically ill patient. Methods: The study was a multicenter, block-randomised, single-blinded, controlled trial conducted at four medical-surgical ICUs at two university hospitals and two regional hospitals. Eligible for the study were patients ≥18 years of age, undergoing mechanical ventilation for ≥24 h, staying in the ICU ≥48 h, with a close relative ≥18 years of age. A total of 116 relatives and 75 patients consented to participate. Outcome measures were scores of posttraumatic stress symptoms, anxiety, depression, and health-related quality of life three months after ICU discharge. Results: Relatives had 26.3% lower scores of posttraumatic stress in the diary group than in the control group (95% confidence interval: 4.8–% to 52.2%). Patients had 11.2% lower scores of posttraumatic stress symptoms in the diary group (95% confidence interval: −15.7% to 46.8%). There were no differences between groups in depression, anxiety, or health-related quality of life. Conclusion: A diary written by relatives for the ICU patient reduced the risk of posttraumatic stress symptoms in relatives. The diary had no effect on depression, anxiety, or health-related life quality. However, as the diary was well received by relatives and proved safe, the diary may be offered to relatives of critically ill patients during their stay in the ICU.

KW - Critical care

KW - Critical care nursing

KW - Family nursing

KW - Intensive care diaries

KW - Posttraumatic

KW - Stress disorders

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DO - 10.1016/j.aucc.2019.01.004

M3 - Journal article

C2 - 30795978

AN - SCOPUS:85061720320

SN - 1036-7314

VL - 33

SP - 123

EP - 129

JO - Australian Critical Care

JF - Australian Critical Care

IS - 2

ER -

The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study)

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