Parents' and Healthcare Providers' Perceptions About the Use of Narrative Diaries in the Neonatal Intensive Care Unit: A Prospective Feasibility Study

Nurs Crit Care. 2026 May;31(3):e70472. doi: 10.1111/nicc.70472.

Abstract

Background: Admission to the neonatal intensive care unit (NICU) is a challenging experience for parents. The use of narrative diaries could be a helpful support strategy to reduce psychological complications.

Aim: To describe feasibility in terms of acceptability, demand and implementation of a narrative diary in the NICU and explore parents' and healthcare providers' (HCPs) perceptions and attitudes on its use.

Study design: Prospective feasibility study using quantitative and qualitative approaches was conducted in a NICU at a tertiary care children's hospital in Italy. Participants are newborns admitted to the NICU, their families and HCPs. The narrative NICU diary intervention was assessed in terms of adherence, type of entries and perceptions on satisfaction, usability and usefulness.

Results: Twenty-three parents of critically ill newborns participated in this study between January 2024 and July 2025. The median length of NICU stay was 38 days (IQR: 27-48). Sixteen caregivers were mothers (84%). A total of 581, entries were collected in 21 diaries, with a median of 22 (IQR: 12-38) entries per diary and a median NICU diary duration of 30 (IQR: 20-51) days per family. Parents contributed at least once a day in 350/951 diary-days (37%), while HCPs contributed in 49/951 diary-days (5%). At 1-month follow-up after NICU discharge, 19 (83%) parents reported high levels of satisfaction and usefulness on a 1-10 Likert Scale (LS) with the diary for themselves and their newborn (LS = 9; IQR: 8-10). At the end of the study, 17 (24%) NICU HCPs reported greater usefulness of the diary for parents (LS = 9; IQR: 7-10) than for themselves (LS = 7; IQR: 5-9).

Conclusions: The implementation of a narrative NICU diary was feasible and perceived as beneficial by both parents and HCPs.

Relevance to clinical practice: The use of a narrative NICU diary may support parents and prevent the family post-intensive care syndrome (PICS-f). Strategies are needed to promote diary writing by HCPs.

Keywords: caregivers; diary; neonatal intensive care unit; parents; post‐intensive care syndrome.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Diaries as Topic*
  • Feasibility Studies
  • Female
  • Health Personnel* / psychology
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal* / organization & administration
  • Italy
  • Male
  • Narration*
  • Parents* / psychology
  • Perception*
  • Prospective Studies
  • Qualitative Research