Diary as a Tool to Mitigate Post-Traumatic Stress in Intensive Care Patients: An Integrative Review

Abstract

Introduction: The Intensive Care Unit (ICU) environment may sometimes contribute to the development of Post-Traumatic Stress Disorder (PTSD) in critically ill patients. The use of ICU Diaries has been proposed as a promising tool to mitigate these effects and enhance patients’ emotional recovery. Objective: To analyse recent scientific literature on the impact of ICU Diaries as a tool to mitigate PTSD, identifying their feasibility and impact on patients' psychological well-being. Material and Methods: An integrative literature review following the Joanna Briggs Institute (JBI) methodology. The search was conducted in the PubMed, CINAHL, and Cochrane databases, including studies published between 2019 and 2024. Inclusion criteria comprised critically ill patients over 18 years old with no prior psychiatric disorders; studies involving patients with previous psychiatric conditions or dementia were excluded. Results: ICU Diaries appear to reduce PTSD symptoms when combined with complementary interventions. They improve the organisation of hospitalisation memories, reducing memory fragmentation. However, the benefits for family members were limited, particularly in reducing anxiety levels, and study findings were inconsistent. The review identified methodological limitations, such as small sample sizes, lack of blinding, and short follow-up periods, which compromise the clinical applicability of the findings. Furthermore, variability in outcome assessment methods and selection bias hinder direct comparisons between studies. Conclusion: ICU Diaries appear to be a promising strategy for mitigating PTSD and improving patients’ memory organisation, but methodological heterogeneity compromises their clinical applicability. Future studies should establish clear protocols, assess long-term impact, and consider the cost-effectiveness of the intervention.