Constructing the illness narrative: A grounded theory exploring patientsʼ and relativesʼ use of intensive care diaries
- 1 August 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 39 (8), 1922-1928
- https://doi.org/10.1097/ccm.0b013e31821e89c8
Abstract
After a stay in the intensive care unit, patients risk experiencing delusional memories, memory loss, and symptoms of posttraumatic stress. Since the 1990s, diaries have been kept for intensive care unit patients to help fill in memory gaps, aid psychosocial recovery, and improve health-related quality of life. More insight is needed into the application of diaries. The aim of our study was to explore how patients and relatives use diaries in the context of the illness trajectory. Qualitative multicentered design using in-depth semistructured interview technique. A nine-bed general intensive care unit and a 13-bed thoracic surgical intensive care unit in Denmark. A sample of 19 patients at 6-12 months postintensive care unit discharge and 13 relatives (n = 32). Intensive care diaries and handover 1 or 3 months postintensive care unit discharge. Grounded theory method was used to explore the use of diaries as a psychosocial process of recovery involving patients and relatives. Data were managed by NVivo software. The core category was "constructing the illness narrative," which was a process of narration embedded in our emerging theory of psychosocial recovery after critical illness. The main categories within the patient perspective were information acquisition and gaining insight, and the main categories within the relative perspective were supporting the patient, supporting oneself, and negotiating access. Intensive care diaries are useful to patients as well as their relatives. Patients need to construct their illness narrative, and diaries are among the sources they use. The patients' project was to combine various sources of information in a process of information acquisition, narration, and evolving insight progressing toward recovery. The relatives supported the patients' project and also supported themselves by using the diary to uphold their own healing process. We recommend intensive care diaries as a low-technology, low-cost rehabilitative intervention for patients and relatives to help bridge the span from intensive care to recovery.This publication has 36 references indexed in Scilit:
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