The Patient's Perspective of the Intensive Care Unit Diary in the Cardiac Intensive Care Unit

Background: Many patients who survive an intensive care unit admission develop post-intensive care syndrome and face significant long-term physical, cognitive, and mental health impairments. The intensive care unit diary is a reality-sorting tool that is effective in aiding patients to connect their flashbacks and delusional memories to actual events.

Objectives: To describe implementation of an intensive care unit diary in the cardiac intensive care unit and to describe the patient's perspective of the diary.

Methods: Consent for participation in the study was given by the patient health care proxy or a family member. The study consisted of 3 phases: writing in the diary about the patient's events in the cardiac intensive care unit, a follow-up visit with the patient within 1 week of cardiac intensive care unit transfer, and a follow-up telephone call 2 months after hospital discharge.

Results: Of 26 patients, 13 completed all phases of the study. Four themes were identified from the transcripts of the patients' responses: (1) The diary allowed patients to correlate memories to actual events, (2) it enabled patients to read about their families' experiences during their critical illness, (3) recovery was an emotional process that affected the patient's readiness to read the diary, and (4) patients expressed a desire for more entries by caregivers.

Conclusions: The intensive care unit diary can help patients gain clarity of their time in the cardiac intensive care unit. Additional research on the use of the diary and long-term patient follow-up is warranted.