护理SCI晨读:家属使用重症监护日记的经验:系统评价和定性综合

2021
04/27

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家属用各种各样的方式使用日记,包括作为一种应对的方式,一种保持联系的方式,作为一种理解和发展关于经历的叙述的工具。


护理SCI晨读:

家属使用重症监护日记的经验:系统评价和定性综合

 



 



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摘要

背景

重症监护病人日记由医护人员和/或家属撰写,在世界各地的重症监护病房(ICUs)得到广泛应用。虽然写日记的初衷是为了帮助重症监护室的病人康复,但最近的研究重点是写日记对病人家属的潜在益处。尽管定性研究表明,家属认为日记是一种有用的应对策略,对家属心理健康影响的定量研究Meta分析发现日记的影响并不一致。


目标


评价和综合定性研究,观察家属在ICU日记中书写的经验。


设计


系统的回顾和定性的综合。


数据源


使用CINAHL、MEDLINE、PsycInfo、Central、PTSDHubs和已出版的国际文献网科学会议论文集引文索引-科学、社会科学和人文科学进行结构化搜索。


综述方法


纳入所有在任何时间发表的研究,纳入标准为包含家属使用ICU患者日记体验的定性数据(包括混合方法研究)。从收录的文章中提取主题和叙述语句并加以综合。采用关键评估技能计划(CASP)定性检查表和混合方法评估工具(MMAT)对文献进行质量评估。


结果


共纳入16篇研究,其中定性研究13篇,混合研究3篇。确定的主题是:1:应对( 子主题1.1 以情绪为中心的应对和1.2应对 ) 2:联系(子主题:2.1沟通方式2.2关系的发展与维护)和3:展开叙述(子主题3.1理解3.2塑造故事3.3记忆)。


结论


家属用各种各样的方式使用日记,包括作为一种应对的方式,一种保持联系的方式,作为一种理解和发展关于经历的叙述的工具。这些发现将ICU日记的使用与书面情绪暴露、创伤后成长和意义创造的文献联系起来。家属使用ICU日记、应对策略和/或创伤后成长之间的关系可能是未来定量试验的重点。

 

Abstract

Background

Intensive care patient diaries written by staff and/or relatives are widely used in intensive care units (ICUs) across the world. Although the original aim of the diaries was to support patients in their recovery from ICU, a more recent focus of the literature has been the potential benefit of the diaries to the relatives of patients. Meta-analyses of quantitative studies looking at the impact on the psychological wellbeing of relatives have not consistently found an effect of the diaries, even though qualitative studies suggest that relatives find the diaries to be a useful coping strategy.

Objectives

To evaluate and synthesise qualitative studies looking at the experience of relatives writing in ICU diaries.

Design

A systematic review and qualitative synthesis.

Data sources

A structured search using CINAHL, MEDLINE, PsycInfo, Cochrane Central Register of Controlled Trials (CENTRAL), PTSDHubs and Published International Literature Web of Science Conference Proceedings Citation Index - Science and Social Science and Humanities was conducted.

Review methods

All studies published at any time that included qualitative data (including mixed methods studies) about the perceptions of relatives using ICU patient diaries were included. Themes and narrative statements were extracted from included articles and synthesised. Articles were quality assessed using the Critical Appraisal Skills Programme (CASP) qualitative checklist and Mixed Methods Appraisal Tool (MMAT).

Results

Sixteen studies were included in the review, thirteen qualitative and three mixed methods articles. The themes identified were: 1. Coping (subthemes: 1.1. Emotion-Focused Coping and 1.2. Problem-Focused Coping) 2. Connection (subthemes: 2.1 Method of Communication and 2.2 Developing and maintaining relationships) 3. Developing a Narrative (subthemes 3.1 Understanding 3.2 Shaping the story 3.3 Remembering).

Conclusions

Relatives use the diaries in a variety of ways including as a means of coping, a way of staying connected, as a tool to understand and develop a narrative about the experience. These findings link the use of ICU diaries with literature on written emotional exposure, post-traumatic growth and meaning making. The relationship between a relative's use of the ICU diary, coping strategies and/or post-traumatic growth could be a focus for future quantitative trials.

PROSPERO protocol number CRD42020165869




文链接:

https://www.sciencedirect.com/science/article/pii/S0020748921000675


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关键词:
ICU,重症,监护,护理,研究

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