The implementation and impact of narrative diaries in neonatal intensive care units: A scoping review.

Abstract

Background: Premature birth and the Neonatal Intensive Care Unit (NICU) experience can be challenging for parents, affecting their psychological and emotional well-being. NICU diaries could help to reduce the separation gap and strengthen the bonding process with their infant.

Aim: To review the literature on narrative diaries, definitions and use in the NICU.

Study design: We conducted a scoping review following the Joanna Briggs Institute (JBI) methodology. We searched PubMed, Embase, Scopus, PsycINFO, Cinahl, and Grey Literature up to September 2024. Studies reporting on the use or effect of narrative diaries in the NICU were included. A descriptive and thematic analysis was conducted.

Results: Of a total of 526 records, 21 were included. Most studies had a quasi-experimental or qualitative design, including a framework conceptualization. Editorials were common. Mothers (33%), nurses (9%) and fathers (5%) were the most common diarists. Seven studies evaluated the effect of NICU diaries on family post-intensive care syndrome (PICS-F), satisfaction, and family separation. The benefits of NICU diaries for parents included improved communication, empowerment, personal emotional awareness and parental closeness with their newborn, while for staff, they reduced burnout and fostered the humanization of care. Acceptability was high.

Conclusions: Acceptability and perceived benefits of NICU diaries were widely reported. Heterogeneity in aims, use, and follow-up was high. Well-designed effective multicentre studies providing evidence of impact on PICS-F and a position statement framing the intervention in NICU are recommended.

Relevance to clinical practice: This study has shown that NICU diaries have the potential to improve humanization, communication between NICU staff and parents, parents' coping, and closeness to their newborn.