Thematic Analysis: How do patient diaries affect survivors' psychological recovery?

Aim: This review aims to use thematic analysis to explore and synthesise evidence of the actual or potential reported effects of diaries on the psychological rehabilitation and recovery of discharged critical care patients. Background: Evidence suggests that whilst admission to critical care may save patient lives, the psychological aftermath can damage a patient’s recovery and these needs must be met. Patient diaries are one potential intervention to aid patients understand their critical illness and fill memory gaps caused by sedation, thus reducing psychological distress post-discharge. Prospective patient diaries are increasing in popularity amongst critical care units in the United Kingdom, however there is little evidence base to support their use or understand their effects. Method: A literature review using systematic methods was undertaken of studies relating to the effects of diaries on discharged patients. Thematic analysis enabled the generation and synthesis of themes. Results: Three themes arose from the generated codes: 1) Reclaiming ownership of lost time. 2) Emphasising personhood. 3) Fear and frustration. The diary intervention was shown to have a largely positive impact on survivors’ psychological rehabilitation. However, caution should be exercised as recipients could find the contents painful and emotional. Diaries should be embedded within a robust critical care follow-up plan. Conclusion: This review suggests that diaries have the potential to form one aspect of rehabilitation and make a positive impact on patients’ recovery. More research is indicated to fully evaluate the effects of diaries on their recipients.