Aloud Real-time Reading of ICU Diaries for Prevention of Negative Post-ICU Psychological Outcomes: A Feasibility Study

Overview

About this study

Over a third of those who survive critical illness suffer from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). This is twice as high as the rates of PTSD in combat veterans. The strongest risk factor is memories of frightening experiences and delusions (something that is very common during critical illness, when patients feel that something is real when it is actually not). Patients can hear speech even when sedated, yet there is no systematic communication with the critically ill while they receive life-saving medical treatments. We think that lack of real-time communication with patients contributes to their traumatic memories, because patients may not understand why they experience something painful, and what is happening to them. We therefore propose to modify an already existing intervention called ICU diaries to provide this real time communication. Currently it is one of the most commonly used interventions and consists of the treating team and family members writing down the daily events in a diary that the patient receives sometime after the hospital discharge. Unfortunately, ICU diaries have not shown consistent results, perhaps because when the patient reads about their ICU stay, they have already formed traumatic memories of that experience. Aloud reading of ICU diaries in real-time creates a method for systematically ensuring delivery of patient-orientated communication for ICU patients. This communication may therefore prevent negative psychological sequela in ICU survivors by orienting patients to their surroundings and situation; encouraging accurate memories and recall of the ICU experience. Prior to performing a larger study powered to evaluate the efficacy of this intervention on ICU survivor outcomes, we will perform an initial feasibility study to improve upon the current proposed protocol. We plan to assess feasibility via enrollment of 30 patients into a prospective cohort study where compliance with completing diary tasks can be measured and input from important stakeholders such as patients, patient families, room nurses, and physical/occupational therapists can be obtained and evaluated. This study is to determine the feasibility of providing psychological support to ICU patients through reading aloud standard of care daily diary entries by the care team which will be evaluated through feedback from patients and their family members

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inculsion Criteria

  1. High risk critically ill patients: adults (age ≥18) in acute respiratory failure and/or requiring vasopressors admitted to the ICU and expected to stay >48 hours. adults (age ≥18) in acute respiratory failure and/or requiring vasopressors admitted to the ICU and expected to stay >48 hours
  2. Enrolled patient’s family members.
  3. Critical care nurses.
  4. Physical/Occupational therapists writing ICU diary entries.

 

Exclusion Criteria:

  1. History of dementia, mental retardation, suicide attempt, psychotic disorders such as schizophrenia, acute alcohol/substance intoxication or withdrawal, severe metabolic encephalopathy; patients on comfort care; patients not expected to survive the hospital stay or non-English speaking

 

 

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Lioudmila Karnatovskaia, M.D.

Open for enrollment

Contact information:

Lioudmila Karnatovskaia M.D.

(904) 953-2000

Karnatovskaia.Lioudmila@mayo.edu

More information

Publications

Publications are currently not available
.
CLS-20503088

Mayo Clinic Footer