The extent and application of patient diaries in Danish ICUs in 2006

The aim of this study was to describe the extent and application of patient diaries in Danish intensive care units (ICUs) in 2006. Following critical illness, many patients experience disturbed and disconnected memories. Patient diaries in the ICU have been introduced locally by nurses in the Scandinavian countries and the UK as a means to improve cognitive recovery and prevent psychological trauma following critical illness. Descriptive design, using qualitative key informant telephone interviews (n= 19) was used as the source of data. A semi-structured interview guide was used and field notes from the interviews were mailed to the informants for verification and additional information. Nineteen out of 48 Danish ICUs use patient diaries. Patient diaries are mainly used for sedated, ventilated patients during critical illness. The purpose of diaries was mainly to assist memory due to post-ICU amnesia. There was no systematic follow-up after the ICU stay. The study showed a number of legal and ethical issues that still need to be resolved. Patient diaries are ambiguous documents that are neither the property of the hospital nor the patient. The diaries have been implemented at Danish ICUs without a plan for the assessment of their effect, thus bypassing established control mechanisms that evaluate the usefulness of an intervention, such as Health Technology Assessment or nursing research.