A Constructivist Grounded Theory Study on the Use of Patient Diaries in pAediatric inTensive carE from parents’ and nurses’ perspectives: The UPDATE Study

ORCID

Abstract

Background: The paediatric intensive care unit (PICU) is a highly stressful environment affecting children, families and staff. Patient diaries, common in adult intensive care and valued for supporting psychological recovery, are less established in PICUs. Further research is needed to address gaps in understanding diary impact within paediatric settings. Aim: The aim of the study was to examine how PICU patient diaries are used by children, families and HCPs. Study Design: The qualitative approach, Constructivist Grounded Theory, was adopted to ground the meanings and actions constructed by the participants. Eleven families were intensively interviewed initially during their child's PICU admission to a combined general and cardiac unit in the UK. Six families were interviewed post-discharge from the hospital, at follow-up. Ninety-five nurses and health care assistants were interviewed in five focus group interviews. Findings: PICU diaries provided a communication tool which strengthened relationships between the parent and their child, nurses and other family members by Creating Connections. The relationships fostered were viewed as Impacting Emotionally on parents and nurses. In an environment with an imbalance of power, the diary supported parental autonomy by Empowering Involvement to make decisions. Providing clear explanations of their child's PICU admission, the patient diary filled any gaps in memory and offered an easily understandable permanent record. Therefore, the diary was a valuable resource supporting Making Sense of the child's complex critical illness journey. Conclusions: The UPDATE study provides an understanding of the role of PICU diaries as a tool for both parents and nurses. These diaries serve as clear and accessible records, bridging gaps in knowledge. By empowering families and healthcare professionals, PICU diaries support the navigation of the complexities inherent in PICU admissions and contribute to Making Sense to enhance clinical practice and compassionate care. Relevance to Clinical Practice: The theory generated offers understanding of the impact and use of PICU diaries and the multidimensional use of the diary for the child's parents and nurses to explain and understand the critical illness experience.

Publication Date

2026-03-13

Publication Title

Nursing in Critical Care

Volume

31

Issue

2

ISSN

1362-1017

Acceptance Date

2026-02-12

Deposit Date

2026-05-06

Embargo Period

2027-03-13

Keywords

diary, family-centred care, intensive care units, MeSH, Paediatric, paediatrics, post-intensive care syndrome, psychological support

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This item is under embargo until 13 March 2027

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