Work

Effect of diary intervention on sleep quality and risk of stress disorders among critically ill children in pediatric intensive care units and on their parents’ anxiety level: A randomized controlled trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: OBJECTIVES: To investigate benefits of diary intervention in a pediatric intensive care unit (PICU) on sleep quality and stress-related disorders in critically ill children and anxiety and depression in their parents. METHODS: This single-blind, two-arm, randomized controlled trial enrolled 94 dyads. The control group (n = 47) received standard care; the experimental group (n = 47) additionally received a diary intervention. We compared the sleep quality and stress disorders of children, and anxiety, depression, and stress disorders among parents at various time-points, between groups. RESULTS: Data of 83 dyads were ultimately analyzed (loss-to-visit rate: 11.7 %). During the PICU stay, the experimental group showed significantly shorter total awakening time of each sleep episode and mean duration of each awakening per sleep session than the control group (P = 0.006; P = 0.032). The Childhood Stress Disorder Checklist scores of children in the experimental group were significantly lower than those in the control group at 1 and 3 months post-discharge (P = 0.003; P = 0.006). Parents in the experimental group reported significantly lower anxiety scores at PICU discharge and 1 month thereafter (P < 0.001; P = 0.015). At discharge, depression scores were significantly lower in the experimental group; this difference remained significant at 1 and 3 months post-discharge (P < 0.001; P < 0.05). At PICU discharge, parental scores were significantly lower in the experimental group than in the control group (P < 0.001). CONCLUSIONS: The PICU diary intervention effectively improved the children's sleep quality and was associated with stress reduction in parents during their children's PICU stay and up to 3 months post-discharge. The intervention was also associated with a reduction in negative parental emotions up to 3 months after PICU discharge. IMPLICATIONS FOR CLINICAL PRACTICE: These findings offer valuable insights into supporting the psychological well-being of pediatric patients and their caregivers during and after PICU admission.

Source: Intensive and Critical Care Nursing

DOI: 10.1016/j.iccn.2025.104315

Authors: Yingshuang He, Yuhong Zhang, Huining Xin, Jinling Lin, Shuting Lin, Sijia Li, Xiao Cheng, Guihua Liu, Jinhua Liao

Institutions: Fujian Medical University, Baoshan College of Traditional Chinese Medicine, Fujian Provincial Hospital, Fujian Women and Children Hospital

Language: English

Topic: Family and Patient Care in Intensive Care Units

Subfield: Radiological and Ultrasound Technology

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,140