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Research Objectives
To examine caregivers’ use of a pediatric intensive care unit (PICU) journal, assess
perceived benefits, and identify journal optimization.
Design
Quality Improvement Study.
Setting
A 36-bed tertiary care PICU in a children's hospital.
Participants
All families of children with an anticipated PICU stay of >72 hours were provided
the journal. Caregivers were invited to participate if they were >18 years old and
read and write fluent English.
Interventions
A PICU journal designed to support caregivers during their child's illness through:
1. self-expression prompts; 2. monitoring their child's progress; 3. familiarization
with the PICU environment; 4. facilitating communication; and 5. preparation for post-hospital
recovery.
Main Outcome Measures
A study-made survey to quantitatively and qualitatively assess caregivers’ reported
journal use and experiences, including their perceived benefits and suggested optimization.
Descriptive statistics and qualitative narrative analysis were conducted.
Results
We distributed journals to 135 caregivers from September 2021-August 2022 and 68 (50%)
provided feedback. Of those, 36 (53%) reported journal use. Five of the caregivers
who did not use the journal reported using a personal journal. Caregivers who used
the PICU journal agreed-to-strongly agreed that the journal helped them communicate
with the medical team (93%), manage feelings of anxiety (89%), and understand PICU
care (70%). Monitoring their child's progress was ranked as the most helpful component
of the journal. Themes identified through narrative analysis pertained to improving
journal implementation (e.g., timing of delivery, support with use) and customizability
(e.g., size, ability to add more pages).
Conclusions
PICU journals hold potential for supporting caregivers during their child's critical
illness. However, the ability to customize the journal for individual needs and availability
of a journal ‘champion’ to support implementation are important barriers to address
to optimize effective use.
Author(s) Disclosures
This work was supported in part by the NIH (K23HD106011) and UPMC CHP Foundation.
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© 2022 Published by Elsevier Inc.
