Development and Preliminary Evaluation of a Structured Narrative Nursing Log for Conscious Patients in the Intensive...

This study aimed to develop a structured narrative nursing log, grounded in narrative nursing theory, for use with conscious patients in the intensive care unit (ICU), and to conduct a preliminary clinical evaluation of its effectiveness.

A structured narrative nursing log was developed through literature review, group brainstorming, and expert consultation. A quasi-experimental design was adopted. The study included 90 conscious ICU patients from a Class III Grade A hospital in Nantong, Jiangsu Province, selected via convenience sampling. Participants were assigned to either the control group (n = 46), in which nurses documented care using a blank nursing log, or the intervention group (n = 44), in which nurses utilized the structured narrative nursing log developed in this study. Primary outcome measures included patient-reported anxiety levels, perceived caring, time spent by ICU nurses on narrative nursing, and nurses' sense of professional fulfillment.

Patients in the intervention group exhibited significantly lower anxiety levels and significantly higher perceived caring compared to those in the control group (p < 0.05; 95% CI, 2.33-3.72). The average time spent on narrative nursing was also significantly lower in the intervention group (25.05 ± 1.94 minutes) than in the control group (34.07 ± 3.93 minutes) (p < 0.05; 95% CI, 7.71-10.33). Among the 43 participating ICU nurses, a statistically significant increase in self-reported professional fulfillment was observed following implementation of the structured log (p < 0.05; 95% CI, -10.95 to -6.40).

The structured narrative nursing log shows promise in reducing anxiety-related symptoms, improving patients' perception of care, and enhancing nurses' sense of professional accomplishment. These findings suggest its potential value in refining nursing practices for conscious patients in intensive care settings.