Authors (including presenting author) :
Ng NT (1), Lai SF (1)
Affiliation :
Intensive Care Unit, Princess Margaret Hospital
Introduction :
Studies reveal that 1/3 of ICU survivors experienced anxiety and some psychological aftermath during the first year of recovery. Without adequate attention and proper treatment, the symptoms might even contribute to anxiety disorder, depression or post-traumatic stress disorder (PTSD). Patient diary is a text record of significant events during patient’s stay in ICU. Prior research suggests that the diaries can significantly help in reduction of PTSD related to critical illnesses or ICU treatments.
Objectives :
•to provide coherent memories and promote patients’ psychological wellbeing; •to explore patients’ view in patient diary; and •to evaluate nursing staff’s satisfaction in patient diary.
Methodology :
A pilot project on patient diary was carried out in 2016. Inclusion criteria were: 1. ICU patients who were communicable and able to read, 2. with a length of stay for at least 24 hours, 3. preferably either obstetric, post cardiac arrest or post-traumatic injuries patients. Nurses were educated to record patients’ remarkable events during their stay in ICU. Nurses, doctors, allied health and even family members were encouraged to write some words on the solicitude part of the diary. The diary was given to the patient upon discharge from ICU. Outcome measures were categorized as: 1) patients’ view in patient diary and 2) satisfaction rating from the nursing staff.
Result & Outcome :
From May, 2016 to August 2018, 80 samples were recruited. 4 of them were interviewed upon discharge from ICU. Positive feedback was obtained from the patients and their family members. Most patients expressed gratitude upon receiving the diaries. They regarded the patient diary as a ‘gift and blessing’ from the ICU nursing team and some of them described it as a ‘special caring act’. Also, increasing number of thank-you cards and appreciation letters were received along with the implementation of patient diary. For staff satisfaction, over 60% of nurses were satisfied with the project. The mean satisfaction score was 3.2/5. Most of them expressed that patient diary was a meaningful act for the patients. However, some might concern that some entries were unpleasant and might not be beneficial to the patients. ICU patient diary is a simple act in promoting patients’ psychological wellness. The pilot project shows that patient diary is a ‘gift of care’ to both ICU nurses and patients. Thus, the project was fully implemented in September, 2018. Yet, project enhancement implies a need to conduct further studies to investigate the cultural and ethnic influence on the implementation of patient diary in Hong Kong.