Impact of patient diaries on children, families, and healthcare professionals in paediatric intensive care settings: A scoping review

Objective

The aim of this scoping review was to understand the current landscape, features, and volume of evidence that address the review question: what is the impact of Paediatric Intensive Care Unit (PICU) patient diaries on children, families, and healthcare professionals (HCPs)? To provide context: descriptions of diary models was also provided.

Method

The search strategy was structured using the Population, Concept, and Context model to focus the review question. The inclusion criteria were intentionally broad to include all studies published in English from January 2016 until November 2024. The databases CINAHL, Medline, and EMBASE were used to retrieve articles, and grey literature was scoped using Google Scholar. Articles were reviewed and summarised.

Results

Thirteen articles on the impact of PICU diaries have provided understanding on: the definition of PICU diaries, and perspectives on how diaries impacted the child, parents, and the HCP. The studies were mostly conducted in Europe. The methods used in the studies were quantitative (n = 4), qualitative (n = 4), mixed methods (n = 1), prospective descriptive study (n = 1), and a quality improvement project (n = 1). Two papers were scoping and systematic reviews and included for completeness. PICU diaries are well received but there are implementation challenges, and concerns about the professional implications of diary use.

Conclusion

The literature scoped provided insights on the variety of diary models, the perceived value, and challenges of using diaries, whilst illuminating the current gaps in the evidence around the impact of PICU diaries.

Implications for clinical Practice

PICU diaries represent a low-cost, feasible intervention that enhances understanding and fosters stronger connections between parents, their child, and healthcare professionals. While PICU staff generally evaluated the diaries positively, concerns regarding professional and legal implications persist. Further research and professional guidance are needed to address these concerns and establish best practices for diary use in the PICU setting.