Open Access Research

Phenomenologic analysis of healthcare worker perceptions of intensive care unit diaries

Antoine Perier12, Anne Revah-Levy23, Cédric Bruel4, Nathalie Cousin4, Stéphanie Angeli4, Sandie Brochon4, François Philippart45, Adeline Max4, Charles Gregoire4, Benoit Misset45 and Maité Garrouste-Orgeas46*

  • * Corresponding author: Maité Garrouste-Orgeas mgarrouste@hpsj.fr

  • † Equal contributors

Author Affiliations

1 Maison des Adolescents, University Hospital Cochin; 75014 Paris, France

2 INSERM U-669, Paris Sud University and Paris Descartes University, UMR-S0669, Paris, France

3 Centre de Soins Psychothérapiques pour Adolescents, Argenteuil Hospital, Argenteuil, France

4 Medical ICU, Saint Joseph Hospital Network, 75014 Paris, France

5 René Descartes University, 75005 Paris, France

6 University Joseph Fourier, Integrated Research Center U823 "Epidemiology of Cancers and Severe Diseases," Albert Bonniot Institute, Rond-point de la Chantourne, 38706 La Tronche Cedex, France

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Critical Care 2013, 17:R13  doi:10.1186/cc11938

Published: 21 January 2013

Abstract

Introduction

Studies have reported associations between diaries kept for intensive care unit (ICU) patients and long-term quality-of-life and psychological outcomes in patients and their relatives. Little was known about perceptions of healthcare workers reading and writing in the diaries. We investigated healthcare worker perceptions the better to understand their opinions and responses to reading and writing in the diaries.

Methods

We used a phenomenologic approach to conduct a qualitative study of 36 semistructured interviews in a medical-surgical ICU in a 460-bed tertiary hospital.

Results

Two domains of perception were assessed: reading and writing in the diaries. These two domains led to four main themes in the ICU workers' perceptions: suffering of the families; using the diary as a source of information for families but also as generating difficulties in writing bad news; determining the optimal interpersonal distance with the patient and relatives; and using the diary as a tool for constructing a narrative of the patient's ICU stay.

Conclusions

The ICU workers thought that the diary was beneficial in communicating the suffering of families while providing comfort and helping to build the patient's ICU narrative. They reported strong emotions related to the diaries and a perception of intruding into the patients' and families' privacy when reading the diaries. Fear of strong emotional investment may adversely affect the ability of ICU workers to perform their duties optimally. ICU workers are in favor of ICU diaries, but activation by the diaries of emotions among younger ICU workers may require specific support.