The effect of ICU diaries on the occurrence of impaired mental health and quality of life of ICU SARS-CoV-2 patients and their families: a protocol for an observational cohort study

Abstract

Background: The SARS-CoV-2 pandemic puts patients and their relatives at risk of developing post-intensive care syndrome (PICS and PICS-family). The use of an intensive care unit (ICU) diary for these patients could help fill in memory gaps and complete their fragmented illness narrative. Objectives: The aim of this study is to evaluate the effect of an ICU diary on the occurrence of impaired mental health in patients admitted with a SARS-CoV-2 infection and their relatives. Methods: An observational cohort study of SARS-CoV-2 patients treated in the ICU of Elizabeth-Tweesteden Hospital (ETZ) in Tilburg, The Netherlands will be conducted. Adult patients admitted at the ICU because of respiratory insufficiency due to SARS-CoV-2, who are mechanically ventilated, are included. During treatment in the ICU a diary is kept of the patient. Anxiety, depression and post-traumatic stress disorder, cognitive dysfunction and quality of life will be screened in patients and their relatives by using the psychosocial screening instrument for adult trauma patients (PSIT), the Cognitive Failure Questionnaire (CFQ) and the short-form health survey 36 (SF-36). The recollection of patients’ memory of the ICU stay will be evaluated by the ICU memory tool. The appreciation of the ICU diary will be assessed using a questionnaire. Results: Participants’ characteristics including how they valued the diary, and their memory of ICU treatment will be reported. Multiple logistic regression analysis will be performed for analyzing the relation between mental health outcome and the use of ICU diaries. Change in PICS symptoms over time will be analyzed using longitudinal data analysis. Missing values in questionnaires will be analyzed using missing value analysis and multiple imputations at item level will be performed if necessary. Conclusions: This study will contribute to the knowledge of mental health outcome in SARS-CoV-2 patients and the use of ICU diaries in this group.