Yoğun Bakım Anılarına Bakmak İster misin? Yoğun Bakım Günlükleri

Öz

Yoğun bakım üniteleri, karmaşık tıbbi durumların bir arada olduğu hastalarda sağ kalım oranının artırılması için gerekli olan özel birimlerdir. Ancak sahip olduğu bazı özellikler nedeniyle hasta ve hasta yakınlarının olumsuz durumlar yaşamasına neden olmaktadır. Bu süreçte hastalarda önemli psikolojik ve zihinsel problemler ortaya çıkabilmektedir. Özellikle bilinci kapalı olarak takip edilen hastalarda bilinç yerine geldiğinde hafıza kayıpları ortaya çıkmakta, anksiyete ve depresyon görülebilmektedir. Benzer şekilde hasta yakınlarında da hastalarıyla özellikle bağ kuramamaya bağlı olarak psikolojik semptomlar gelişebilmektedir. Bu olumsuz durumların giderilebilmesi için yoğun bakımlarda günlük yazımı uygulaması 20. yüzyılda sık olarak görülmeye başlamıştır. Ancak olumlu sonuçlar elde edilmesine rağmen Türkiye'deki yoğun bakım ünitelerinde yoğun bakım günlüğü uygulamasını bildiren bir çalışmaya rastlanmamıştır. Bu derlemede yoğun bakım günlükleri kavramı, uygulamanın etkileri ve uygulamaya ilişkin öneriler hakkında bilgi verilecektir. Makalenin yazımında veri tabanlarına “intensive care”, “diary”, “patient”, “patient relatives”, “experience” anahtar kelimeleri girilerek tarama yapılmıştır. Mevcut makalenin ülkemiz yoğun bakımlarında görev yapan başta hemşireler olmak üzere tüm sağlık personelinde farkındalık oluşturması hedeflenmektedir.

Anahtar Kelimeler

• aile üyeleri
• günlük
• hasta
• yoğun bakım

Do You Want to Look at Your Intensive Care Memories? Intensive Care Diaries

Öz

Intensive care units are specialized units designed to improve survival among patients with complex medical conditions. However, certain characteristics of the intensive care environment may lead to adverse experiences for both patients and their relatives. During this process, patients may experience significant psychological and cognitive problems. In particular, patients who are unconscious during their stay in the intensive care unit may experience memory loss, anxiety, and depression after regaining consciousness. Similarly, family members may develop psychological symptoms, particularly due to difficulties in establishing and maintaining a connection with their loved ones. To alleviate these adverse experiences, the practice of keeping intensive care diaries became increasingly common during the 20th century. However, despite the positive outcomes reported in the literature, no study reporting the implementation of intensive care diaries in intensive care units in Türkiye was identified. This review aims to provide information on the concept of intensive care diaries, the effects of this practice, and recommendations for its implementation. For the preparation of this review, databases were searched using the keywords “intensive care,” “diary,” “patient,” “patient relatives,” and “experience.” This review aims to raise awareness of intensive care diaries among healthcare professionals working in intensive care units in Türkiye, particularly nurses.

Anahtar Kelimeler

• Family Members
• Diary
• Patient
• Intensive Care

Kaynakça

1. 1. Leblebicioğlu H, Nair Aktaş F. Covid-19 salgınıyla mücadele: Yoğun bakım hemşireliği meslek ve kişisel etik perspektifi. Yoğun Bakım Hemş Derg. 2020;24(Ek- 1):73-80.
2. 2. Calzari S, Villa M, Mauro S, et al. The intensive care unit diary as a valuable care tool: A qualitative study of patients’ experiences. Intensive Crit Care Nurs. 2024;80:103558.
3. 3. Hiser SL, Fatima A, Ali M, Needham DM. Post-intensive care syndrome (PICS): Recent updates. J Intensive Care. 2023;11(1):23.
4. 4. Gazzato A, Scquizzato T, Imbriaco G, et al. The effect of intensive care unit diaries on posttraumatic stress disorder, anxiety, and depression: A systematic review and meta- analysis of randomized controlled trials. Dimens Crit Care Nurs. 2022;41:256-263.
5. 5. Yao L, Li Y, Yin R, et al. Incidence and influencing factors of post-intensive care cognitive impairment. Intensive Crit Care Nurs. 2021;67:1-9.
6. 6. Munoz-Rey MP, Delgado-Hito P, Juve-Udina ME, Cuzco-Cabellos C, Huertas-Zurriaga A, Romero-Garcia M. The diary in the intensive care unit: Concept analysis. Enferm Intensive. 2024;35:178-187.
7. 7. Inoue S, Hatakeyama J, Kondo Y, et al. Post-intensive care syndrome: Its pathophysiology, prevention, and future directions. Acute Med Surg. 2019;6 (3):233-246.
8. 8. Haakma T, Tieben R, Sleven B, Buise M, van Mol M. Experiences of nurses with an innovative digital diary intervention in the intensive care unit: A qualitative exploration. Intensive Crit Care Nurs. 2022;70:1-7.

9. 9. Schofield R, Dibb B, Coles-Gale R, Jones CJ. The experience of relatives using intensive care diaries: A systematic review and qualitative synthesis. Int J Nurs Stud. 2021;119:1-12.
10. 10.Bäckman CG, Walther SM. Use of a personal diary written on the ICU during critical illness. Intensive Care Med. 2001;27:426-429.
11. 11.van Mol MM, Tummers N, Leerentveld C, Tieben R, Buise M. The usability of a digital diary from the perspectives of intensive care patients' relatives: A pilot study. Nurs Crit Care. 2024;29(6):1280-1289.
12. 12.Sun X, Huang D, Zeng F, et al. Effect of intensive care unit diary on incidence of posttraumatic stress disorder, anxiety, and depression of adult intensive care unit survivors: A systematic review and meta-analysis. J Adv Nurs. 2021;77(7):2929-2941.
13. 13.Barreto BB, Luz M, Rios MNO, Lopes AA, Gusmao Flores D. The impact of intensive care unit diaries on patients’ and relatives’ outcomes: A systematic review and meta-analysis. Crit Care. 2019;23(1):411.
14. 14.Flahault C, Trosdorf M, Sonrier M, et al. ICU survivors experience of ICU diaries: An ancillary qualitative analysis of the ICU diary study. Crit Care Explor. 2021;3(5):e0384.
15. 15.Barreto BB, Luz M, Alves Valente do Amaral Lopes S, Goulart Rosa R, Gusmao-Flores D. Exploring patients’ perceptions on ICU diaries: A systematic review and qualitative data synthesis. Crit Care Med. 2021;49(7):707-718.
16. 16.Nielsen AH, Cand SA, Cand IE, Lund TH, Renberg M, Hansen TB. The effect of family-authored diaries on posttraumatic stress disorder in intensive care unit patients and their relatives: A randomised controlled trial (DRIP-study). Aust Crit Care. 2020;33(2):123-129.
17. 17.Garrouste-Orgeas M, Flahault C, Vinatier I, et al. Effect of an ICU diary on posttraumatic stress disorder symptoms among patients receiving mechanical ventilation: A randomized clinical trial. JAMA. 2019;322(3):229-239.
18. 18.Tripathy S, Acharya SP, Sahoo AK, et al. Intensive care unit (ICU) diaries and the experiences of patients’ families: A grounded theory approach in a lower middle-income country (LMIC). J Patient Rep Outcomes. 2020;4:1-11.
19. 19.Högvall LM, Egerod I, Herling SF, Rustøen T, Berntzen H. Finding the right words: A focus group investigation of nurses' experiences of writing diaries for intensive care patients with a poor prognosis. Aust Crit Care. 2023;36(6):1011-1018.
20. 20.Johansson M, Wahlin I, Magnusson L, Hanson E. Nursing staff’s experiences of intensive care unit diaries: A qualitative study. Nurs Crit Care. 2019;24(6):407-413.
21. 21.Holme AN, Halvorsen K, Eskerud RS, et al. Nurses’ experiences of ICU diaries following implementation of national recommendations for diaries in intensive care units: A quality improvement project. Intensive Crit Care Nurs. 2020;59:1-6.