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      Implementação de diário em terapia intensiva: percepção de familiares e da equipe de enfermagem Translated title: Implementación del diario en cuidados intensivos: percepción de la familia y del equipo de enfermería Translated title: Implementation of intensive care diary: perception of the family and the nursing team

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          Abstract

          Resumo Objetivo identificar a percepção de familiares e da equipe de enfermagem sobre a implementação de um diário de Unidade de Terapia Intensiva à rotina de cuidados do paciente crítico. Método estudo descritivo, qualitativo, realizado em uma Unidade de Terapia Intensiva (UTI) adulto, entre julho e outubro de 2022. Implementou-se um diário, com registros de familiares e da equipe de enfermagem. A percepção dos familiares foi identificada através de entrevistas, e a da equipe, por meio de roda de conversa. Utilizou-se análise temática de Minayo. O estudo foi aprovado por Comitê de Ética em Pesquisa. Resultados participaram nove familiares; emergiram as seguintes categorias: Benefícios da utilização do diário de UTI e Fatores que podem influenciar no uso do diário de UTI”. A partir da roda de conversa, com cinco profissionais de enfermagem, evidenciaram-se as categorias: Melhora da conexão com paciente e família; O diário como fonte de informações e Aspectos éticos relacionados aos registros. Considerações finais e implicações para a prática os familiares e os profissionais de enfermagem consideraram o instrumento benéfico, tanto para familiares quanto para pacientes. Para sua implementação, fluxos bem estabelecidos sobre o uso e a aproximação da família são essenciais para subsidiar o processo e obter a adesão das partes envolvidas.

          Translated abstract

          Resumen Objetivo identificar la percepción de los familiares y del equipo de enfermería sobre la implementación del diario de Unidad de Cuidados Intensivos en el cuidado rutinario del paciente crítico. Método estudio descriptivo y cualitativo, realizado en una Unidad de Cuidados Intensivos (UCI) de adultos, entre julio y octubre de 2022. Se implementó un diario, con registros de los familiares y del equipo de enfermería. La percepción de los familiares fue identificada a través de entrevistas y la percepción del equipo a través de una rueda de conversación. Se utilizó el análisis temático de Minayo. El estudio fue aprobado por el Comité de Ética en Investigación. Resultados participaron nueve familiares; surgieron las siguientes categorías: Beneficios del uso del diario de UCI y Factores que pueden influir en el uso del diario de UCI. De la rueda de conversación, con cinco profesionales del equipo de enfermería, se destacaron las categorías: Mejora de la conexión con el paciente y la familia; El diario como fuente de información y Aspectos éticos relacionados con los registros. Consideraciones finales e implicaciones para la práctica los familiares y profesionales de enfermería consideraron beneficioso el instrumento, tanto para los familiares como para los pacientes. Para su implementación, son esenciales flujos bien establecidos sobre el uso y el alcance familiar para respaldar el proceso y obtener la aceptación de las partes involucradas.

          Translated abstract

          Abstract Objective to identify the perception of family members and the nursing team regarding the implementation of an Intensive Care Unit diary into the routine care of critically ill patients. Method descriptive and qualitative study, carried out in an adult Intensive Care Unit (ICU), between July and October/2022. A diary was implemented, with records from family members and the nursing team. The family members' perception was identified through interviews, and the team's perception was identified through a conversation circle. Minayo thematic analysis was used. The study was approved by the Research Ethics Committee. Results nine family members participated; the following categories emerged: Benefits of using the ICU diary and Factors that may influence the use of the ICU diary. From the conversation circle, with five professionals from the nursing team, the categories were highlighted: Improved connection with patient and family; The diary as a source of information and ethical aspects related to records. Final considerations and implications for practice family members and nursing professionals considered the instrument beneficial, both for family members and patients. To support its implementation, well-established flows on use and family outreach are essential to support the process and obtain buy-in from the parties involved.

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          Most cited references28

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          Tradução e validação para a língua portuguesa e avaliação do guia COREQ

          Resumo Objetivo: Traduzir e validar o guia Consolidated Criteria for Reporting Qualitative Research (COREQ) para o português falado no Brasil e verificar o impacto da recomendação do uso COREQ pelos autores em artigos publicados em uma revista científica de Enfermagem Métodos: Estudo metodológico e descritivo. Na primeira etapa, adotou-se protocolo para tradução de instrumentos, em seguida o guia COREQ em português brasileiro foi aplicado para análise da qualidade dos artigos publicados, em uma revista científica, dois anos anteriores e dois anos posteriores à adoção do COREQ pela revista. Resultados: A primeira fase traduziu e validou os 32 itens do COREQ por três juízes e com emprego da Técnica Delphi com índice de concordância entre os juízes de 99%. Na segunda fase, 77 artigos de abordagem qualitativa foram avaliados sendo 25 artigos publicados entre 2014-2015 (antes da adoção do guia pela revista) e 52 artigos entre 2016-2017 (após a adoção do COREQ). Verificou-se diferença estaticamente significativa antes e após a adoção do guia entre cinco itens: Identificação dos autores que conduziram a pesquisa; Apresentação da atividade/ocupação dos autores; Informação sobre o tempo despendido para realização das entrevistas; Informação sobre devolução das entrevistas aos participantes para inserção de comentários e/ou correção pelos mesmos; e Apresentação da descrição da árvore de codificação. As medianas de atendimento aos 32 itens alcançaram 56,3% (antes) e 62,5% (depois), com significância estatística. Conclusão: A tradução do guia foi considerada válida pelos especialistas. A análise da utilização guia pela revista analisada conferiu melhora na qualidade aos artigos publicados.
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            Psychological Sequelae in Family Caregivers of Critically III Intensive Care Unit Patients. A Systematic Review

            Rationale: Family members of critically ill patients hospitalized in the intensive care unit (ICU) often become caregivers, and they are at risk to develop adverse psychological outcomes. There is a need to understand the psychological impact of critical illness on family caregivers. Objectives: The aim of this systematic review is to document the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) in family caregivers of critically ill patients and identify potential risk factors for psychological outcomes to inform clinical and future research recommendations. Methods: A literature search for psychological outcomes for family caregivers of critically ill patients was conducted. A total of 1,148 studies from PsycINFO, CINAHL, Web of Science, SCOPUS, and Medline were identified. Results: Forty studies met inclusion criteria and were included in the review. The prevalence of psychological outcomes in family caregivers ranged from 4% to 94% for depression, 2% to 80% for anxiety, and 3% to 62% for PTSD. Caregiver depression, anxiety, and PTSD decreased in most studies that assessed longitudinal outcomes. Common risk factors identified for adverse psychological outcomes included younger caregiver age, caregiver relationship to the patient, lower socioeconomic status, and female sex. Conclusions: The prevalence of depression, anxiety, and PTSD varies greatly across studies of family caregivers of critically ill patients. This finding highlights the need for more systematic investigations of psychological outcomes and the implementation of clinical interventions to prevent or reduce depression, anxiety, and PTSD in family caregivers of critically ill patients.
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              The impact of intensive care unit diaries on patients’ and relatives’ outcomes: a systematic review and meta-analysis

              Background Memory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient’s factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives. Methods Two authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality (“Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)” for cohort studies and the “Cochrane Risk of Bias tool” for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies. Results Seven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23–0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79–19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression. Conclusion and relevance This systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients. Trial registration PROSPERO, CRD42019136639

                Author and article information

                Journal
                ean
                Escola Anna Nery
                Esc. Anna Nery
                Universidade Federal do Rio de Janeiro (, RJ, Brazil )
                1414-8145
                2177-9465
                2024
                : 28
                : e20230172
                Affiliations
                [01] Porto Alegre Rio Grande do Sul orgnameUniversidade do Vale do Rio dos Sinos orgdiv1Escola da Saúde Brazil
                [02] Porto Alegre Rio Grande do Sul orgnameGrupo Hospitalar Conceição orgdiv1Hospital Nossa Senhora da Conceição Brazil
                Author information
                https://orcid.org/0000-0001-8558-1008
                https://orcid.org/0000-0002-5015-6797
                https://orcid.org/0000-0002-2247-0471
                https://orcid.org/0000-0001-5053-7242
                https://orcid.org/0000-0003-1428-1088
                https://orcid.org/0000-0002-8635-6029
                Article
                S1414-81452024000100212 S1414-8145(24)02800000212
                10.1590/2177-9465-ean-2023-0172pt
                b98a8f0f-4f88-4422-bea4-dadbeb6f355a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 20 December 2023
                : 28 May 2024
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Pesquisa

                Nursing, Team,Diary,Critical Care,Unidades de Cuidado Intensivo,Familia,Equipo de Enfermería,Diario,Cuidados Críticos,Unidades de Terapia Intensiva,Família,Equipe de Enfermagem,Diário,Intensive Care Units,Family

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