Intensive care diary helps patients recover

Clinical scientists at the University and Whiston Hospital Intensive Care Unit (ICU) have led an international clinical study that has halved the development of post traumatic stress in patients following a severe illness.

The study examined whether a diary kept by relatives and nurses during an ICU stay could be used as a therapy to aid the recovery of patients following intensive care.

Earlier research by Professor Richard Griffiths, Professor of Medicine (Intensive Care) in the Department of Musculoskeletal Biology, and Dr Christina Jones, Nurse Consultant for the ICU at Whiston, had shown a strong link between the development of severe post traumatic stress disorder (PTSD) and the delusional experiences that some patients suffer during their ICU stay.

Patients who have required prolonged artificial ventilation have no or very limited recall of their stay except in the later stages, some patients however, instead suffer distressing and vivid delusional nightmare like experiences that seem very real because they are unable to place them in context and dismiss them as false since they lack a true experience of their ICU stay.

The relatives, in contrast, are highly stressed by the actual experience and some can also suffer PTSD symptoms, the group realised that in observational studies, relatives benefit from a detailed understanding of what has happened and it helps to come to terms with their experiences during rehabilitation.

Led by the University team and a collaboration of 12 intensive care units in six European countries called the RACHEL group (Raising Awareness of Chronic Health Events in the Longterm), 350 patients tested such a diary.

It showed that when read during the first few months as a therapy for patients and relatives it could reduce the development of new PTDS from 10% down to 5% of patients.

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