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Preferred content and usefulness of a photodiary as described by ICU-patients-A mixed method analysis
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
Skåne University Hospital, Department of Intensive Care Medicine in Malmö, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
Division of Nursing, Department of Health Sciences, Lund University, Lund, Sweden.
2013 (Engelska)Ingår i: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 26, nr 1, s. 29-35Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Many ICU-patients have memory-gaps which may affect their recovery. A tool in the recovery can be an ICU-diary to explain and clarify thoughts and events from the ICU-period. There are different standards for the content in the ICU-diary. The aim of this study was to identify the preferred content and usefulness of an ICU-diary as described by ICU-patients.

Method: a descriptive, exploratory cohort design with a mixed method approach. The patients answered a questionnaire (n=115) and participated in an interview (n=15) six months after the ICU-stay. Data analysis was carried out in three stages; the questionnaire was analysed by descriptive statistics and categorized by content (four open-ended questions) and the interviews were analysed by manifest content analysis.

Results: The patients explained that detailed information about daily activities and medical facts had to be included to understand and give a sense of coherence of what had happened. The content in the ICU-diary had to be chronological in order to follow the process in which photos were an important part. The patients re-read the ICU-diary during the recovery which helped them to fill in the memory gaps and used it as a tool for communication.

Conclusion; To construct a coherent story, it was essential that the ICU-diary was complete and were amplified by photos, all appearing in a chronological order. The results of this study could form a basis for further developments of standards and guidelines for ICU-diaries

Ort, förlag, år, upplaga, sidor
Elsevier, 2013. Vol. 26, nr 1, s. 29-35
Nyckelord [en]
ICU-diary; ICU-patients; preferred content; usefulness; mixed method
Nationell ämneskategori
Medicin och hälsovetenskap Omvårdnad
Identifikatorer
URN: urn:nbn:se:hj:diva-17967DOI: 10.1016/j.aucc.2012.04.002ISI: 000315945900008PubMedID: 22633052Scopus ID: 2-s2.0-84875380099OAI: oai:DiVA.org:hj-17967DiVA, id: diva2:516860
Tillgänglig från: 2012-04-20 Skapad: 2012-04-20 Senast uppdaterad: 2018-10-22Bibliografiskt granskad
Ingår i avhandling
1. Assessment and tools for follow-up of patients' recovery after Intensive Care
Öppna denna publikation i ny flik eller fönster >>Assessment and tools for follow-up of patients' recovery after Intensive Care
2012 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Aim: The overall aim of this thesis was to describe and explore the use and content of ICU-diaries and to develop and psychometrically test a questionnaire to detect physical and psychosocial problems for ICU patients in their recovery process.

 Methods: This thesis is based on four studies. Study I had an explorative descriptive design with a quantitative and qualitative approach. Data were collected by telephone interviews with staff at Swedish ICUs (n = 65) which kept ICU-diaries. One question “what was the purpose of keeping ICU-diaries” was analysed with latent content analysis, and the other data were analysed with descriptive and comparative statistics. Study II had an explorative descriptive cohort design with a concurrent mixed method approach. The sample in study II was a part of the sample in study IV in which 421 former ICU patients responded to a new developed questionnaire 3-set 4P two months after discharge from ICU. Patients from this sample who have had an ICU-diary (n = 115) responded to a questionnaire six months after discharge from ICU. Fifteen patients were interviewed about the content and usefulness of the ICU-diary. Data were analysed with descriptive statistics, descriptively by content and interviews with manifest content analysis and then combined at the interpretive level to seek convergence, as enable by the mixed method approach. Study III had a methodological design. In this study, the questionnaire 3-set 4P was developed and psychometrically tested in a pilot setting. In study IV, the questionnaire was further developed and tested based on psychometric evaluation of the 3-set 4P. In study III the questionnaire was responded by 39 patients and in study IV by 421 patients. Data in study III and IV were analysed with descriptive statistics and psychometrical tests.

 Results: The main purpose for keeping ICU-diaries was to provide a tool in the recovery by helping the patient remember and give time back. Keeping ICU-diaries was common although there was a difference in practice and patient recruitment among different hospitals (study I). An ICU-diary with content and photos in a chronological order describing the whole picture of critical illness and ICU stay could be a tool for the patient to construct a coherent individual story. The ICU-diary could be one piece to give a deeper understanding and meaning in the personal story and to give a realistic expectation of the recovery process. Absence of guidelines for keeping ICU-diaries could affect the possibility for the ICU-diary to be a helpful tool during the recovery process (study II). In study III, the 3-set 4P was developed to be used for identifying and evaluating former ICU patients’ physical, psychosocial problems and outcome during follow-up. The psychometrical tests showed acceptable validity and internal consistency reliability. The stability reliability was acceptable in two of three sets. The psychometrical tests of the further modified version of 3-set 4P in study IV showed good construct validity and internal consistency but it needs some modification before it can be used in clinical practice (study IV).

 Conclusion: Recovery can be a difficult process where different tools can be useful. Today there is no evidence about tools to use during follow-up. To promote high quality of the follow-up there is a need for evidence-based guidelines. The ICU-diary is one tool but this thesis shows that guidelines for keeping ICU-diaries have to be developed to meet the patients’ wishes in order for the ICU-diary to become a useful tool during the process to recovery. The 3-set 4P can after some modification be used at the follow-up clinic to identify the individual patient’s problems and create an individual program for recovery.

Ort, förlag, år, upplaga, sidor
Jönköping: School of Health Sciences Jönköping University, 2012. s. 88
Serie
Dissertation Series. School of Health Sciences, ISSN 1654-3602 ; 30
Nationell ämneskategori
Medicin och hälsovetenskap Omvårdnad
Identifikatorer
urn:nbn:se:hj:diva-17969 (URN)978-91-85835-29-4 (ISBN)
Disputation
2012-05-11, Skånes Universitetssjukhus Kvinnokliniken i Malmö, Malmö, 10:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2012-04-20 Skapad: 2012-04-20 Senast uppdaterad: 2012-04-20Bibliografiskt granskad

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