Physical impairment during and between migraine attacks: A daily diary study of patients with chronic migraine.

OBJECTIVE: While a substantial body of research describes the disabling impacts of migraine attacks, less research has described the impacts of migraine on physical functioning between migraine attacks. The objective of this study is to describe physical impairment during and between migraine attacks as a dimension of burden experienced by people living with chronic migraine. METHODS: The physical impairment domain of the Migraine Physical Function Impact Diary was recorded in headache diaries from the Medication Overuse Treatment Strategy trial. Days with moderate to severe headache were used to approximate migraine attacks. Factor analysis and regression analysis were used to describe associations between migraine and physical impairment. RESULTS: 77,662 headache diary entries from 720 participants were analyzed, including 25,414 days with moderate to severe headache, 19,149 days with mild headache, and 33,099 days with no headache. Mean physical impairment score was 41.5 (SD = 26.1) on days with moderate to severe headache, 12.8 (SD = 15.0) on days with mild headache, and 5.2 (SD = 13.1) on days with no headache. Physical impairment on days with mild headache and days with no headache was significantly associated with days since last moderate to severe headache, physical impairment with last moderate to severe headache, mild headache (compared to no headache), depression, hypersensitivities and cranial autonomic symptoms. CONCLUSIONS: Physical impairment occurs on migraine and non-migraine days. Study participants with frequent headaches, symptoms of depression, hypersensitivities and cranial autonomic symptoms experience physical impairment at a higher rate on days with no headache and days with mild headache.Clinical Trial Registration: ClinicalTrials.gov (NCT02764320).

Cancer Survivors' and Care Partners' Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic.

OBJECTIVES: To describe cancer survivors' and care partners' perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. METHODS: Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. RESULTS: Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. CONCLUSIONS: The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. IMPLICATIONS FOR NURSING PRACTICE: Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.

Psychometric Evaluation of the Diary for Irritable Bowel Syndrome Symptoms-Constipation in a Prospective Observational Study.

OBJECTIVES: To evaluate the psychometric properties of the Diary for Irritable Bowel Syndrome Symptoms-Constipation (DIBSS-C), which was developed to support primary and secondary endpoints in irritable bowel syndrome (IBS) with predominant constipation (IBS-C) clinical trials. METHODS: Observational data were collected from 108 adults with IBS-C using a smartphone-type device for 17 days. DIBSS-C data regarding bowel movements (BMs) were collected for each event (along with the Bristol Stool Form Scale); abdominal symptoms were rated each evening. Global status items and the Gastrointestinal Symptom Rating Scale-IBS were completed on day 10 and day 17 and the IBS-Symptom Severity Scale on day 17. Item-level performance, internal consistency reliability, test-retest reliability, and construct validity were evaluated. RESULTS: The Abdominal Symptoms Domain score demonstrated high internal consistency reliability (Cronbach's alpha week 1 = 0.98; week 2 = 0.96) and test-retest reliability (intraclass correlation coefficient [ICC] = 0.93). Test-retest reliability was stronger for abdominal symptoms (ICC = 0.91-0.94) than for the frequency-based BM-related outcomes (ICC = 0.54-0.66). Key construct validity hypotheses were supported by moderate to strong correlations with the corresponding Gastrointestinal Symptom Rating Scale-IBS, IBS-Symptom Severity Scale, and Bristol Stool Form Scale items. All known-groups comparisons were statistically significant for the abdominal symptom items and domain score; evidence for known-groups validity of BM-related outcomes was supportive when based on constipation severity. CONCLUSIONS: The results of this study provided key psychometric evidence for the DIBSS-C, ultimately contributing to its qualification by the US Food and Drug Administration for use in IBS-C clinical trials.

A weekly diary within-individual investigation of the relationship between exposure to bullying behavior, workplace phobia, and posttraumatic stress symptomatology.

Most studies on workplace bullying have adopted a between-person approach, neglecting the potential within-individual fluctuations in the experience of bullying behaviors. However, investigating such fluctuations may prove useful for uncovering processes and mechanisms associated with bullying and its antecedents and consequences as they unfold over time. In the present study, based on recent discoveries on traumatic experiences and posttraumatic stress (PTS), we hypothesized that even short-term exposure to bullying behaviors-such as the exposure that characterizes an individual when the time window considered is a working week-may already have a substantial psychological impact at the within-individual level, as indicated by the experience of PTS symptoms. Additionally, we hypothesized that the development of workplace phobia may act as a mechanism linking the exposure to bullying behaviors during the week and the reported PTS symptomatology, and that person-level vulnerability factors to PTS (e.g., a recent trauma and female gender) accentuate the within-individual relationships. We tested the proposed hypotheses on a sample of 158 workers that were followed for 6 consecutive working weeks for a total of 860 observations. In line with other recent within-individual investigations, we found that exposure to bullying behaviors shows substantial week-level fluctuations. We also found overall support for the hypotheses, including evidence of a within-level lagged impact of bullying behaviors on workplace phobia, suggesting that even nonpersistent exposure to such behaviors is related to potentially nonignorable psychological suffering and PTS symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factibilidad de implementación del diario como herramienta de humanización en una unidad de cuidados intensivos / Feasibility of the implementation of the diary as a humanization tool at an Intensive Care Unit

Objetivo: valorar la factibilidad de implementar el diario como herramienta de humanización en una unidad de cuidados intensivos (UCI) médica de Cataluña sin experiencia previa, en términos de acogida, satisfacción y continuidad de la medida por los profesionales de Enfermería, pacientes y familiares.Método: estudio piloto realizado durante 15 semanas con pacientes ingresados >72 horas en la UCI, sedados y con ventilación mecánica invasiva ≥ 48 horas. Se llevaron a cabo tres fases: 1) Formación a los profesionales de Enfermería, 2) Implementación del diario, y 3) Evaluación de la percepción de la herramienta por parte de los tres grupos con cuestionarios anónimos creados ad hoc.Resultados: se diseñó un diario en papel y se impartieron a los profesionales de Enfermería siete sesiones formativas previas. Se escribieron ocho diarios (uno por paciente) y en seis se insertaron fotografías. Se entregaron cuestionarios a 35 enfermeras, nueve familiares y seis pacientes. Un 83% de las enfermeras consideró que el diario se podría implementar en un futuro, a un 83% de pacientes les gustó leer un diario sobre el día a día de su estancia y a un 89% de los familiares les ayudó a expresar sus pensamientos y emociones. Un 40% de las enfermeras consideró que las fotografías podían resultar traumáticas para el paciente, mientras que a la mayoría de los familiares y pacientes no les pareció así.Conclusiones: este estudio piloto concluye que resulta factible implantar el diario en la UCI. Todos los participantes consideraron que es una herramienta que humaniza los cuidados, mejora la comunicación, la comprensión y la información. (AU)

Objective: to assess the feasibility of implementing the diary as a humanization tool at a clinical Intensive Care Unit (ICU) in Catalonia, without previous experience, in terms of acceptance, satisfaction and continuity of the measure by Nursing professionals, patients and relatives.Method: a pilot study conducted during 15 weeks with patients hospitalized >72 hours at the ICU, under sedation and with invasive mechanical ventilation for ≥ 48 hours. There were three stages: 1) Training for Nursing staff, 2) Implementation of the diary, and 3) Evaluation of the perception of the tool by the three groups, with anonymous questionnaires designed ad hoc.Results: a printed diary was designed, and Nursing professionals received seven training sessions previously. Eight diaries were written (one per patient), and photographs were inserted in six of them. Questionnaires were handed out to 35 nurses, nine relatives and six patients. 83% of the nurses considered that the diary could be implemented in the future, 83% of patients enjoyed reading a diary about the day to day of their hospital stay, and it helped 89% of relatives to express their thoughts and emotions. 40% of nurses considered that photographs could be upsetting for patients, while the majority of relatives and patients thought otherwise.Conclusions: the conclusion of this pilot study is that it is feasible to implement the diary at the ICU. All participants considered that this is a tool that humanizes care, and improves communication, understanding and information. (AU)

The feasibility of daily monitoring in adolescents and young adults with mild intellectual disability or borderline intellectual functioning.

BACKGROUND: It is unclear whether the limitations of young persons with a mild intellectual disability or borderline intellectual functioning preclude feasibility of the daily diary method. METHOD: For 60 consecutive days, 50 participants (Mage = 21.4, 56% male) who receive care in an ambulatory, residential, or juvenile detention setting, self-rated both standardised and personalised diary questions through an app. Diary entries were used for feedback in treatment. Interviews were used to explore acceptability. RESULTS: Average compliance was 70.4%, while 26% of participants dropped out. Compliance was good in ambulatory (88.9%) and residential care (75.6%), but not in the juvenile detention setting (19.4%). The content of self-selected diary items varied widely. Participants deemed the method acceptable. CONCLUSIONS: Daily monitoring is feasible for individuals with a mild intellectual disability or borderline intellectual functioning receiving ambulatory or residential care, and can provide scientists and practitioners with important insights into day-to-day behavioural patterns.

Understanding Heterogeneity Among Simultaneous Alcohol and Marijuana Users: Latent Classes Derived From Daily Diary Data.

OBJECTIVE: Simultaneous use of alcohol and marijuana (SAM) is common among U.S. college students, but little research has examined specific substance use behaviors during SAM use episodes. This study identified latent classes of SAM users based on their SAM, alcohol-only, and marijuana-only use episodes. METHOD: College student SAM users (N = 284; 50.7% female; M age = 19.8 years) completed up to five surveys each day across two 4-week bursts. Latent class analysis (LCA) was used to characterize SAM users based on seven latent class indicators of use behavior. Sex was examined in relation to latent class membership. RESULTS: Five unique classes emerged: Frequent Marijuana-Focused SAM users (21%); Frequent Alcohol-Initiating SAM users (29%); Heavy-Drinking Infrequent SAM users (12%); Moderate SAM users (29%); and Light Infrequent SAM users (9%). These groups were differentiated primarily by their frequency of SAM use, form of marijuana, whether marijuana was used on non-SAM occasions, and whether consequences were experienced. Groups differed significantly by sex. CONCLUSIONS: College student SAM users are heterogeneous with respect not only to their degree of SAM use but also in their pattern of drinking, type of marijuana use, relative focus on alcohol versus marijuana, and risk of experiencing acute negative consequences. Describing this heterogeneity is an important step toward developing interventions for different types of users.

Birth cohort studies using symptom diaries for assessing respiratory diseases-a scoping review.

BACKGROUND: Respiratory infections are the most frequent health problem in childhood leading to morbidity and socioeconomic burden. Studying symptoms of respiratory infections in home based settings requires dedicated prospective cohort studies using diaries. However, no information is available on which birth cohort studies using symptom diary data. A review of birth cohort studies with available symptom diary data, follow-up data, and bio samples is needed to support research collaborations and create potential synergies. METHODS: We conducted a scoping review of birth cohort studies using diaries for the collection of respiratory symptoms. The scoping review was conducted in accordance with the PRISMA Extension. We searched the electronic databases PubMed, Embase, Web of science and CINAHL (last search November 2020) resulting in 5872 records (based on title and abstract screening) eligible for further screening. RESULTS: We examined 735 records as full text articles and finally included 57 according to predefined inclusion criteria. We identified 22 birth cohort studies that collect(ed) data on respiratory symptoms using a symptom diary starting at birth. Numbers of participants ranged from 129 to 8677. Eight studies collected symptom diary information only for the first year of life, nine for the first two years or less and six between three and six years. Most of the cohorts collected biosamples (n = 18) and information on environmental exposures (n = 19). CONCLUSION: Information on respiratory symptoms with daily resolution was collected in several birth cohorts, often including related biosamples, and these data and samples can be used to study full spectrum of infections, particularly including those which did not require medical treatment.

Reflections on psychological resilience: a comparison of three conceptually different operationalizations in predicting mental health.

Background: Psychological resilience refers to the ability to maintain mental health or recover quickly after stress. Despite the popularity of resilience research, there is no consensus understanding or operationalization of resilience. Objective: We plan to compare three indicators of resilience that each involve a different operationalization of the construct: a) General resilience or one's self-reported general ability to overcome adversities; b) Daily resilience as momentarily experienced ability to overcome adversities; and c) Recovery speed evident in the pattern of negative affect recovery after small adversities in daily life. These three indicators are constructed per person to investigate their cross-sectional associations, stability over time, and predictive validity regarding mental health. Methods: Data will be derived from the prospective MIRORR study that comprises 96 individuals at different levels of psychosis risk and contains both single-time assessed questionnaires and 90-days intensive longitudinal data collection at baseline (T0) and three yearly follow-up waves (T1-T3). General resilience is assessed using the Brief Resilience Scale (BRS) at baseline. Daily resilience is measured by averaging daily resilience scores across 90 days. For recovery speed, vector-autoregressive models with consecutive impulse response simulations will be applied to diary data on negative affect and daily stressors to calculate pattern of affect recovery. These indicators will be correlated concurrently (at T0) to assess their overlap and prospectively (between T0 and T1) to estimate their stability. Their predictive potential will be assessed by regression analysis with mental health (SCL-90) as an outcome, resilience indicators as predictors, and stressful life events as a moderator. Conclusion: The comparison of different conceptualizations of psychological resilience can increase our understanding of its multifaceted nature and, in future, help improve diagnostic, prevention and intervention strategies aimed at increasing psychological resilience.

Antecedentes: La resiliencia psicológica se refiere a la habilidad de mantener la salud mental o recuperarse rápidamente después de estrés. A pesar de la popularidad de las investigaciones sobre resiliencia, no existe consenso respecto a la comprensión u operacionalización de la resiliencia.Objetivos: Planificamos comparar tres indicadores de resiliencia en que cada uno involucra una operacionalización diferente del constructo: a) Resiliencia general o la habilidad general autoreportada para superar adversidades; b) Resiliencia diaria como la habilidad experimentada momentáneamente para superar adversidades; y c) Velocidad de recuperación evidente en el patrón de recuperación de afecto negativo tras pequeñas adversidades en la vida diaria. Estos tres indicadores son construidos por persona para investigar sus asociaciones transversales, estabilidad sobre el tiempo, y validez predictiva sobre la salud mental.Métodos: Los datos serán derivados desde el estudio prospectivo MIRORR que comprende 96 individuos a diferentes riesgos de psicosis y contiene cuestionarios aplicados una sola vez y datos intensivos longitudinales colectados 90 días tras el punto de referencia (T0) y tres puntos de seguimiento anuales (T1­T3). La resiliencia general fue evaluada utilizando la Escala de Resiliencia Breve (BRS) al punto de referencia. La resiliencia diaria se mide promediando los puntajes de resiliencia diaria a lo largo de 90 días. Para la velocidad de recuperación, se aplicarán modelos vectoriales autorregresivos con simulaciones de respuestas de impulsos consecutivas a los datos diarios sobre afecto negativo y estresores diarios para calcular el patrón de recuperación afectiva. Estos indicadores se correlacionaran concurrentemente (en T0) para evaluar su superposición y prospectivamente (entre T0 y T1) para estimar su estabilidad. Su potencial predictivo se evaluara mediante un análisis de regresión con salud mental (SCL-90) como resultado, indicadores de resiliencia como predictores, y eventos vitales estresantes como moderador.Conclusión: La comparación de diferentes conceptualizaciones de la resiliencia psicológica puede aumentar nuestra comprensión sobre su naturaleza multifacética y, en el futuro, ayudar a mejorar estrategias de diagnóstico, prevención e intervención enfocadas a aumentar la resiliencia psicológica.

Daily experiences of subjective age discordance and well-being.

Subjective age discordance (SAD) captures the difference between how old one feels and how old one would ideally like to be. We investigated the presence, strength, and fluctuation of this discordance in daily life as well as its relationship to various indicators of physical and psychological well-being with an 8-day diary study. Participants were 116 older and 107 younger adults who completed daily measures of felt age, ideal age, positive and negative affect, physical symptoms, and stressors. We operationalized SAD as felt age minus ideal age divided by chronological age and compared the utility of this discordance to the more established proportional discrepancy of felt age from chronological age. Daily SAD was present in both age groups, such that individuals idealized younger ages than they felt. This discordance was larger in older than younger adults, although younger adults exhibited more daily fluctuations in SAD. Within-person increases in SAD were associated with lower positive affect, whereas larger SAD at the between-person level was associated with more physical symptoms and stressors. These relationships were over and above the associations of felt and chronological age with the outcomes suggesting the utility of daily SAD for understanding daily physical and psychological well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Exploring daily time-use patterns: ATUS-X data extractor and online diary visualization tool.

Time-use data can often be perceived as inaccessible by non-specialists due to their unique format. This article introduces the ATUS-X diary visualization tool that aims to address the accessibility issue and expand the user base of time-use data by providing users with opportunity to quickly visualize their own subsamples of the American Time Use Survey Data Extractor (ATUS-X). Complementing the ATUS-X, the online tool provides an easy point-and-click interface, making data exploration readily accessible in a visual form. The tool can benefit a wider academic audience, policy-makers, non-academic researchers, and journalists by removing accessibility barriers to time use diaries.

Distal and proximal family contextual effects on adolescents' interparental conflict appraisals: A daily diary study.

Adolescent appraisals of interparental conflict (IPC)-perceiving IPC as threatening to their well-being or that of the family, and self-blaming attributions-are well-established processes through which IPC confers risk for developmental disruptions and psychopathology. Recent work documents intraindividual change in IPC and appraisals that occur on a daily timescale. However, considerably less is known about how the broader family context may temper appraisals of IPC. This study provides a novel examination of the implications of distal (global ratings of family relationships in general) and proximal (fluctuations in daily family relationships) family context (family cohesion, parent-adolescent closeness, and parent-adolescent conflict) for adolescents' propensity to form negative appraisals of daily IPC. This sample included 144 adolescents (63% female) in two-parent families, who participated in a 21-day daily diary study. Findings indicate that intraindividual variability in adolescents' perception of family cohesion, parent-adolescent closeness, and parent-adolescent conflict all correspond to adolescent appraisals of IPC through direct relations and moderating effects. Unique patterns emerged for boys and girls, suggesting gender differences in how adolescents incorporate the family context into their appraisals of IPC. This study expands our awareness of the importance of daily fluctuations in family relationships for adolescent risk during exposure to IPC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Within- and between-person factor structure of the Oldenburg Burnout Inventory: Analysis of a diary study using multilevel confirmatory factor analysis.

The study examined the factor structure of burnout, as measured with the Oldenburg Burnout Inventory. The participants were 235 employees of a public administration agency who assessed their burnout online for 10 consecutive working days. Two models were tested with multilevel confirmatory factor analysis, assuming the same one or two-factor structure at the within- and between-person levels. Both models showed a reasonable fit to the data, but due to a strong correlation between exhaustion and disengagement and low within-person reliability for disengagement, a unidimensional model seems more valid. A cross-level invariance was not confirmed for either of the structures, showing that factor loadings for the same items differ significantly between the levels. This suggests that burnout is not the same latent variable at each level; rather, there are factors other than daily burnout that influence person-level scores and ignoring these across-level discrepancies may lead to biased conclusions.

When Unnecessary Tasks Weigh Heavily on the Back: A Diary Study on Musculoskeletal Pain.

BACKGROUND: Auxiliary tasks such as administrative work often include tasks that are unnecessary in the view of workers but still have to be done. These tasks can threaten a worker's self-esteem. The purpose of this study was to examine the effects of unnecessary and unreasonable tasks on musculoskeletal pain. METHODS: Fifty-five office workers (29 male; mean age = 41.96, SD = 14.2 years) reported their unnecessary and unreasonable tasks at the beginning of the study and kept a diary of their daily musculoskeletal pain over 5 weeks, using a visual analogue scale. Other work-related risk factors (prolonged sitting), job resources (participation in decision-making), and individual risk factors (sex, smoking, exercise, body mass index, maladaptive back beliefs) were controlled for in multilevel regression analysis. FINDINGS: Multilevel regression analysis with 742 reports showed unnecessary tasks (B = 4.27, p = .006)-but not unreasonable tasks (B = 3.05, p = .074)-to predict the daily intensity of musculoskeletal pain, beyond other significant risk factors, such as prolonged sitting (B = 2.06, p = .039), body mass index (B = 1.52, p < .001), and maladaptive back beliefs (B = 3.78, p = .003). Participation in decision-making was not a significant protective factor (B = -1.67, p = .176). CONCLUSIONS/APPLICATION TO PRACTICE: The higher frequency of unnecessary tasks-compared with unreasonable tasks-could place workers at risk for musculoskeletal pain. Work redesign that reduces unnecessary and unreasonable tasks can make a valuable contribution to worker health and safety among office workers.

Presleep Arousal and Sleep in Early Childhood.

Research suggests that arousal during the transition to sleep-presleep arousal-is associated with sleep disturbances. Although a robust literature has examined the role of presleep arousal in conferring risk for sleep disturbances in adults, substantially less research has examined the developmental origins of presleep arousal in early childhood. The authors examined presleep arousal using parent report and psychophysiological measures in a sample of preschoolers to explore the association between different measures of presleep arousal, and to examine how nightly presleep arousal is associated with sleep. Participants included 29 children assessed at 54 months of age. Presleep arousal was measured using parent reports of child arousal each night at bedtime and using a wearable device that took minute-by-minute recordings of heart rate, peripheral skin temperature, and electrodermal activity each night during the child's bedtime routine. This yielded a dataset with 4,550 min of ambulatory recordings across an average of 3.52 nights per child (SD = 1.84 nights per child; range = 1-8 nights). Sleep was estimated using actigraphy. Findings demonstrated an association between parent-reported and psychophysiological arousal, including heart rate, peripheral skin temperature, and skin conductance responses during the child's bedtime routine. Both the parent report and psychophysiological measures of presleep arousal showed some associations with poorer sleep, with the most robust associations occurring between presleep arousal and sleep onset latency. Behavioral and biological measures of hyperarousal at bedtime are associated with poorer sleep in young children. Findings provide early evidence of the utility of wearable devices for assessing individual differences in presleep arousal in early childhood.

Exploring Patients' Perceptions on ICU Diaries: A Systematic Review and Qualitative Data Synthesis.

OBJECTIVES: This study aims to summarize the current qualitative evidence on patients' experiences of reading the ICU diaries. DATA SOURCES: We searched the online databases PubMed, Ovid, EMBASE, and EBSCO host from inception to July 2020. STUDY SELECTION: All studies that presented any qualitative findings regarding patients' experiences of reading an ICU diary were included. DATA EXTRACTION: Study design, location, publication year, data collection method, and mode, all qualitative themes identified and reported, and participant quotations, when appropriate. We also extracted data regarding the diary structure, when available. A thematic synthesis approach was used to analyze and synthesize qualitative data. DATA SYNTHESIS: Seventeen studies were analyzed. Most patients reported positive experiences with the ICU diary, such as understanding what they survived during critical illness, better understanding the process of recovery, gaining coherence of nightmares and delusional memories, realizing the importance of the presence of family and loved ones during ICU stay, and humanizing healthcare professionals that helped them survive critical illness. Patients also reported which components of the diary were important for their recovery, such as the presence of photographs and reading the diary with a healthcare professional, allowing the improvement of the concept of the ICU diary. CONCLUSION: This qualitative synthesis shows that patients recommend having an ICU diary, enlightening benefits such as better coping with the slow recovery from critical illness, strengthening family ties, and humanizing the ICU staff. It also identifies characteristics of the diary valued by the patients, in order to standardize the ICU diary according to their perspectives, and allowing future comparability between randomized controlled trials.