Newsletter March 2025
05/03/25 13:20 Filed in: News-Ticker
Dear Friends of the ICU Diary,
We hope you are all doing well!
The working group on family- and child-friendly intensive care units of the German Society of Intensive Care Medicine (DIVI), Section on Critical Care Rehabilitation is sending you this newsletter on ICU diaries and psychosocial aspects of intensive care medicine and nursing.
As always, we have summarized several studies on ICU diaries and family-centered care for you and also report on some other interesting articles!
Enjoy reading!
Chu-Won, Kristin, Manuel, Maria, and Peter
WEBINARS
Save the Date:
A new international conference on ICU diaries will be held online, spread over 5 events, each lasting 90 minutes:
• June 10: Introduction and updates to ICU Diaries Link
• June 17: ICU Diaries in Special Settings Link
• June 24: Digital ICU Diaries? Link
• July 1: Lived Experiences of Diaries of Patients and Relatives Link
• July 8: PICS and Aftercare/Follow-up Link
This conference is organized by Bev Ewens (Australia), L. Gallie (UK), C. Jones (UK), L. Karnatovskaia (USA), and P. Nydahl (Germany).
STUDIES ABOUT ICU DIARIES
Digital Diaries
Digital ICU diaries offer several advantages over traditional paper-based versions; however, their implementation in clinical practice remains challenging. Schol et al. (2025) conducted a multicenter, cross-sectional survey among 214 intensive care professionals across four Dutch hospitals to identify key factors for the successful adoption of digital diaries. Participants evaluated 34 aspects across four domains: implementation and use, training and education, availability for relatives, and healthcare professionals’ involvement in writing.
The most critical success factors identified were ease of access (93.5% agreement), engagement of key stakeholders to promote the project (88.8%), and comprehensive training (86%). The preferred training method was direct instruction by team members (90.7%). Relatives were more likely to accept the diary if they understood its benefits (94.9%). Additionally, 61.7% of respondents supported co-authorship with relatives.
Limitations of the study include its restriction to Dutch hospitals and potential selection bias. The authors recommend targeted training, early team involvement, and clear communication strategies to enhance acceptance. These findings are highly relevant for the potential digitalization of ICU diaries.
Schol CMA, Ista E, Rinket M, Berger E, Gommers DAMPJ, van Mol MMC. Determinants of digital ICU diary implementation and use by ICU professionals: A cross-sectional survey analysis. Intensive Crit Care Nurs. 2024 Dec 28;87:103921. Link
Emotional Responses of Patients to Diaries
Patients who survive intensive care treatment often experience post-traumatic distress. An ICU diarymay aid in processing their experiences. Villa et al. (2025) conducted a qualitative study in Italy to explore former ICU patients' perceptions of their intensive care diary. They conducted semi-structured telephone interviews with ten patients who had undergone intensive care treatment between December 2019 and April 2021. The diaries were maintained during the patients' ICU stays and provided to them after discharge.
The results indicate that the ICU diary was perceived as a valuable tool for filling memory gaps and reconstructing experiences. Patients reported that it helped them understand events during their stay, comprehend their relatives' experiences, and appreciate the care provided by medical staff. While many expressed positive emotions, such as gratitude and relief, some also reported painful memories associated with reading the diary.
Limitations of the study include the small sample size and its focus on a single ICU. Villa et al. recommend establishing ICU diaries as a standard tool in post-discharge care. For intensive care, this study highlights the importance of emotional support for patients after hospital discharge.
Villa M, Morale V, Valverde B, Andreossi M, Chinali I, Vigo V, Valentino A, Cesana M, Citterio S, Lucchini A. Exploring the Impact of ICU Diary on ICU Survivors' Emotions and Feelings: A Qualitative Study. Dimens Crit Care Nurs. 2025 Jan-Feb 01;44(1):20-27 Link
Do Diaries Have No Effect on PTSD?
Patients who survive intensive care treatment frequently suffer from post-traumatic stress disorder (PTSD), anxiety, and depression. Shibata et al. (2024) conducted a prospective comparative study in Japan to assess whether ICU diaries reduce these psychiatric symptoms three months after hospital discharge. The study included 61 critically ill adults who had received intensive care for at least two days and were provided with an ICU diary maintained by healthcare staff and relatives. Their outcomes were compared to a historical cohort of 74 patients from an earlier study who did not receive a diary.
The study found no significant difference in PTSD symptom prevalence between the ICU diary group (19%) and the control group (16%). However, anxiety symptoms (25% vs. 38%) and depression symptoms (29% vs. 45%) were numerically lower in the ICU diary group, although these differences were not statistically significant. Seventy percent of patients found the diary useful, with only a few reporting discrepancies between the diary and their own recollections.
Limitations of the study include the small sample size, lack of consideration for relatives, and the impact of the COVID-19 pandemic on visitation policies. While the findings suggest potential benefits of ICU diaries, they also emphasize the need for larger, multicenter studies. For intensive care in Germany, this study underscores the importance of targeted post-discharge support. Time for a new meta-analysis!
Shibata M, Miyamoto K, Shima N, Nakashima T, Fukushima J, Yamada S, Kimoto S, Inoue S. The effect of ICU diary on psychiatric symptoms after ICU discharge among adult critically ill patients: A prospective comparative study. Acute Med Surg. 2024 Nov 28;11(1):e70026 Link
Diaries in Neonatology
Preterm birth and treatment in the neonatal intensive care unit (NICU) pose significant psychological and emotional stress for parents. Narrative diaries may help bridge the separation and strengthen parent-child bonding. Sorrentino et al. (2025) conducted a scoping review following the Joanna Briggs Institute methodology, systematically searching PubMed, Embase, Scopus, PsycINFO, Cinahl, and gray literature up to September 2024 for studies on the use of narrative diaries in the NICU. A total of 21 out of 526 studies were included in the review.
Most studies employed a quasi-experimental or qualitative design. The most frequent contributors to diary entries were mothers (33%), nurses (9%), and fathers (5%). Seven studies examined the impact of diaries on Post-Intensive Care Syndrome-Family (PICS-F), parental satisfaction, and family separation. The use of diaries was associated with improved communication and emotional awareness among parents, enhanced parent-child bonding, and reduced burnout among healthcare staff.
While acceptance of diaries was high, there was substantial heterogeneity in study objectives, implementation strategies, and follow-up methods. The authors recommend multicenter studies to evaluate the effects on PICS-F and advocate for standardized implementation of narrative diaries in neonatal intensive care.
Sorrentino G, Thekkan KR, Genna C, Aite L, Ragni A, Bevilacqua F, Dall'Oglio I, Roberti M, Tiozzo E, Gawronski O. The implementation and impact of narrative diaries in neonatal intensive care units: A scoping review. Nurs Crit Care. 2025 Mar;30(2):e13281. Link
Family Care Diary
A Family Care Diary was introduced in this single-center study to systematically incorporate family feedback on their experiences in the pediatric intensive care unit (PICU) into patient care. The diary allowed families to record information about treatment and the care team, as well as their questions and thoughts.
In an evaluation involving 306 families, three-quarters of respondents rated the intervention as highly beneficial. The study indicates that most families found the diary helpful for communication with the PICU team. Additionally, the diary provided valuable feedback to the medical staff, highlighting both areas of excellence (e.g., quality of nursing care) and areas for improvement (e.g., communication processes).
Tcharmtchi, J., Coss‐Bu, J. A., & Tcharmtchi, M. H. (2024). Enhancing family experience in the paediatric intensive care unit through the adoption of the family care journal: A single‐center study. Nursing in Critical Care. Link
Publication in Apotheken Umschau
Journalist N. Himmer has published an article on ICU diaries in Apotheken Umschau, a medical journal in plain language, available for free in every pharmacy in Germany. While this may seem trivial at first, Apotheken Umschau is Germany’s largest health magazine, with a circulation of 9 million copies, playing a key role in public health education.
An article on ICU diaries in such a widely read publication could increase awareness and encourage more families of ICU patients to adopt this simple yet effective intervention. Ideally, this will also promote the introduction of diaries in ICUs where they are not yet in use. We sincerely thank Ms. Himmer for her valuable contribution! Link
RELATED STUDIES
Some titles were sourced from the @ICURehab Newsletter by Dale M. Needham and Critical Care Reviews by Rob Mac Sweeney. These were edited and supplemented with findings from our own searches.
SCCM Guideline on Family-Centered Care: The Society of Critical Care Medicine (SCCM) has released an updated guideline on family-centered care, presenting 17 recommendations:
You can find the guideline and a tool for implementation here: Link
Families & Virtual Reality (VR): A randomized controlled trial (RCT) involving 180 family members examined whether providing ICU-related information via VR headsets compared to standard care had any benefits in reducing anxiety, depression, or PTSD after six months. The study found no significant differences between the groups. Drop et al (2025) from the Netherlands Link
Delirium Prevention Through Family Involvement: A meta-analysis of 11 RCTs including 3,113 ICU patients compared family-integrated care to standard care regarding delirium outcomes. Family involvement led to a 50% reduction in delirium incidence, a shorter delirium duration (by approximately two days), and a 1.5-day reduction in ICU length of stay.
The most effective approach was direct family participation in patient care (RR 0.37), followed by visitation and companionship (RR 0.56) and indirect involvement (RR 0.77). Li et al. (2025) Link
Concepts for Family Integration: A systematic review of 14 studies identified four key concepts for integrating families into ICU care: dignity and respect, participation in patient care, information exchange, and collaboration. These concepts were generally associated with increased family satisfaction and a reduction in anxiety and depression. However, further research is needed to refine and differentiate their impact. Joo et al (2024) Link
Emotional Limbo: The Needs of Families: An analysis of 124 studies on family needs identified a central theme: emotional limbo and extreme moments. Key supportive measures include responding to families' needs, facilitating reciprocal communication, and fostering a compassionate and humane atmosphere in the ICU. Gunnlaugsdottir et al (2025) Link
Impact-ICU: A study on post-ICU follow-up care is being planned in Canada. The intervention includes ICU diaries, informational materials on the post-ICU period, and follow-up meetings at one and three months. The control group will receive standard care. The study aims to evaluate feasibility, recruitment, adherence, and other key parameters. Jawa et al. (2025) from Canada. Link
Core Outcome Set: In this Delphi study, a multistage survey involving healthcare professionals, patients, and relatives, six key outcomes were identified for ICU survivors: survival, freedom from life-sustaining measures, absence of delirium, hospital discharge, health-related quality of life, and cognitive function. Kjaer et al. (2025) Link
Family Support: Among 196 family members of ICU patients, the Caregiver Pathway—which includes a meeting with intensive care staff, a support card, a follow-up phone call after discharge, and post-ICU follow-up within three months—was associated with a reduction in PICS-F (PTSD, anxiety, and depression) compared to standard care in families of ICU survivors. RCT von Watland et al (2024) from Norway Link
Personalized Music: According to interviews with 14 critically ill patients, listening to personalized music was associated with several benefits, including restoring awareness, maintaining cognitive function, humanizing the hospital experience, fostering connection, improving psychological well-being, and addressing the challenges of silence. Menza et al (2024) from the USA Link
Cognitive Rehabilitation: An umbrella review on cognitive rehabilitation during and after intensive care analyzed 13 meta-syntheses encompassing 29 original studies. Various multicomponent interventions combining cognitive and physical activities were identified, including peer support groups, exercise manuals, relaxation techniques, Sudoku, and television-based interventions. Due to the heterogeneity of the studies, no specific recommendations could be made regarding intervention type, timing, duration, or target populations. Holm et al. (2024) Link
Delirium & Family: An intervention using a family member’s voice for re-orientation, prevention, and treatment of delirium in ICU patients was found to be feasible and was positively received by patients, relatives, and healthcare staff. Johnson et al. (2024) from Australia Link
Culturally Sensitive Communication: A Delphi study developed 13 recommendations for culturally sensitive communication with families of patients at the end of life. Key aspects include supporting families in performing cultural, spiritual, and religious rituals and customs, promoting family involvement in discussions on treatment limitations, and ensuring healthcare professionals have access to training in culturally sensitive communication. Brooks et al (2025) from Australia Link
PICS: The U.S. journal Critical Care Clinics has published a special issue on Post-Intensive Care Syndrome (PICS), PICS-F (family impact), and PICS-p (pediatric impact). This edition includes articles on physical, psychological, cognitive, social, and financial aspects, as well as topics such as sedation, the A2F Bundle, rehabilitation, follow-up care, and health equity. Link
Pediatric Studies
Supporting Children Through Farewell Processes: Children are welcome as visitors in intensive care units. When visiting a dying patient for the last time, this experience can help them understand the situation, but it also requires professional guidance and support. Rowland et al (2025) Link
End-of-life: End-of-life decisions in pediatric intensive care and neonatology are guided by ethical principles. A systematic review summarizing nine papers analyzed existing guidelines and recommendations for such situations. Twelve ethical principles were identified, including singularity, dignity, proportionality, purposefulness, non-maleficence, justice (resource allocation), professional duty, beneficence, truthfulness, autonomy, the right to optimal treatment, and the right to self-determined life. Beneficence was cited as the most frequently emphasized principle. Špoljar et al (2025) Link
Follow-Up Care for Children: What does follow-up care look like for children who have been treated in an ICU? A review of 68 studies examining follow-up assessments found that post-ICU care concepts vary widely in terms of timing, involved healthcare professionals, and assessment methods. The most common follow-up time points were at discharge, 3, 6, and 12 months, with only 20% of studies reporting follow-ups beyond one year. One-third of the studies focused on quality of life and neurological parameters, while only 7% assessed the emotional burden on parents. The findings underscore the need for standardized follow-up care, particularly to address Post-Intensive Care Syndrome in children (PICS-p). Micaëlli et al. (2025). Link
The Way Home – A Psychoanalytic Case Report: This case report from Brazil describes the psychological support provided to a family (mother, father, and three-year-old son) with premature twins, from their admission to the neonatal intensive care unit (NICU) until approximately six weeks after discharge. The focus is particularly on the mother's experience, the development of her bond with the children, and the role of the NICU in this process. The authors adopt a psychoanalytic approach, characterized by unfiltered documentation of subjective impressions and recurrent use of visual analogies. A distinctive feature of the study is the use of clinical diaries, which serve as a tool to capture immediate perceptions and form the basis of the case description. Giguer, F et al (2025) Link
Did We Miss a Study?
We cannot review and summarize every study. If we have overlooked an important one, please send us a short summary and a reference via email, and we will gladly include it in the newsletter!
Stay healthy!
Chu-Won, Kristin, Manuel, Maria & Peter
Dr. Chu-Won Sim, M.Sc. – Psychologist, Department of Pediatric Cardiology, German Heart Center of Charité (DHZC), Berlin, Germany
Kristin Gabriel – Media Scientist, Art Historian, and Yoga Instructor, Berlin
Manuel Köpper, M.Sc. – Psychologist, Pediatric Intensive Care Unit, University Hospital Tübingen, Germany
Maria Brauchle, GKP – Nursing School Vorarlberg, Feldkirch, Austria
PD Dr. Peter Nydahl, RN BScN MScN – Nursing Research, University Hospital Schleswig-Holstein, Kiel, Germany
We hope you are all doing well!
The working group on family- and child-friendly intensive care units of the German Society of Intensive Care Medicine (DIVI), Section on Critical Care Rehabilitation is sending you this newsletter on ICU diaries and psychosocial aspects of intensive care medicine and nursing.
As always, we have summarized several studies on ICU diaries and family-centered care for you and also report on some other interesting articles!
Enjoy reading!
Chu-Won, Kristin, Manuel, Maria, and Peter
WEBINARS
Save the Date:
A new international conference on ICU diaries will be held online, spread over 5 events, each lasting 90 minutes:
• June 10: Introduction and updates to ICU Diaries Link
• June 17: ICU Diaries in Special Settings Link
• June 24: Digital ICU Diaries? Link
• July 1: Lived Experiences of Diaries of Patients and Relatives Link
• July 8: PICS and Aftercare/Follow-up Link
This conference is organized by Bev Ewens (Australia), L. Gallie (UK), C. Jones (UK), L. Karnatovskaia (USA), and P. Nydahl (Germany).
STUDIES ABOUT ICU DIARIES
Digital Diaries
Digital ICU diaries offer several advantages over traditional paper-based versions; however, their implementation in clinical practice remains challenging. Schol et al. (2025) conducted a multicenter, cross-sectional survey among 214 intensive care professionals across four Dutch hospitals to identify key factors for the successful adoption of digital diaries. Participants evaluated 34 aspects across four domains: implementation and use, training and education, availability for relatives, and healthcare professionals’ involvement in writing.
The most critical success factors identified were ease of access (93.5% agreement), engagement of key stakeholders to promote the project (88.8%), and comprehensive training (86%). The preferred training method was direct instruction by team members (90.7%). Relatives were more likely to accept the diary if they understood its benefits (94.9%). Additionally, 61.7% of respondents supported co-authorship with relatives.
Limitations of the study include its restriction to Dutch hospitals and potential selection bias. The authors recommend targeted training, early team involvement, and clear communication strategies to enhance acceptance. These findings are highly relevant for the potential digitalization of ICU diaries.
Schol CMA, Ista E, Rinket M, Berger E, Gommers DAMPJ, van Mol MMC. Determinants of digital ICU diary implementation and use by ICU professionals: A cross-sectional survey analysis. Intensive Crit Care Nurs. 2024 Dec 28;87:103921. Link
Emotional Responses of Patients to Diaries
Patients who survive intensive care treatment often experience post-traumatic distress. An ICU diarymay aid in processing their experiences. Villa et al. (2025) conducted a qualitative study in Italy to explore former ICU patients' perceptions of their intensive care diary. They conducted semi-structured telephone interviews with ten patients who had undergone intensive care treatment between December 2019 and April 2021. The diaries were maintained during the patients' ICU stays and provided to them after discharge.
The results indicate that the ICU diary was perceived as a valuable tool for filling memory gaps and reconstructing experiences. Patients reported that it helped them understand events during their stay, comprehend their relatives' experiences, and appreciate the care provided by medical staff. While many expressed positive emotions, such as gratitude and relief, some also reported painful memories associated with reading the diary.
Limitations of the study include the small sample size and its focus on a single ICU. Villa et al. recommend establishing ICU diaries as a standard tool in post-discharge care. For intensive care, this study highlights the importance of emotional support for patients after hospital discharge.
Villa M, Morale V, Valverde B, Andreossi M, Chinali I, Vigo V, Valentino A, Cesana M, Citterio S, Lucchini A. Exploring the Impact of ICU Diary on ICU Survivors' Emotions and Feelings: A Qualitative Study. Dimens Crit Care Nurs. 2025 Jan-Feb 01;44(1):20-27 Link
Do Diaries Have No Effect on PTSD?
Patients who survive intensive care treatment frequently suffer from post-traumatic stress disorder (PTSD), anxiety, and depression. Shibata et al. (2024) conducted a prospective comparative study in Japan to assess whether ICU diaries reduce these psychiatric symptoms three months after hospital discharge. The study included 61 critically ill adults who had received intensive care for at least two days and were provided with an ICU diary maintained by healthcare staff and relatives. Their outcomes were compared to a historical cohort of 74 patients from an earlier study who did not receive a diary.
The study found no significant difference in PTSD symptom prevalence between the ICU diary group (19%) and the control group (16%). However, anxiety symptoms (25% vs. 38%) and depression symptoms (29% vs. 45%) were numerically lower in the ICU diary group, although these differences were not statistically significant. Seventy percent of patients found the diary useful, with only a few reporting discrepancies between the diary and their own recollections.
Limitations of the study include the small sample size, lack of consideration for relatives, and the impact of the COVID-19 pandemic on visitation policies. While the findings suggest potential benefits of ICU diaries, they also emphasize the need for larger, multicenter studies. For intensive care in Germany, this study underscores the importance of targeted post-discharge support. Time for a new meta-analysis!
Shibata M, Miyamoto K, Shima N, Nakashima T, Fukushima J, Yamada S, Kimoto S, Inoue S. The effect of ICU diary on psychiatric symptoms after ICU discharge among adult critically ill patients: A prospective comparative study. Acute Med Surg. 2024 Nov 28;11(1):e70026 Link
Diaries in Neonatology
Preterm birth and treatment in the neonatal intensive care unit (NICU) pose significant psychological and emotional stress for parents. Narrative diaries may help bridge the separation and strengthen parent-child bonding. Sorrentino et al. (2025) conducted a scoping review following the Joanna Briggs Institute methodology, systematically searching PubMed, Embase, Scopus, PsycINFO, Cinahl, and gray literature up to September 2024 for studies on the use of narrative diaries in the NICU. A total of 21 out of 526 studies were included in the review.
Most studies employed a quasi-experimental or qualitative design. The most frequent contributors to diary entries were mothers (33%), nurses (9%), and fathers (5%). Seven studies examined the impact of diaries on Post-Intensive Care Syndrome-Family (PICS-F), parental satisfaction, and family separation. The use of diaries was associated with improved communication and emotional awareness among parents, enhanced parent-child bonding, and reduced burnout among healthcare staff.
While acceptance of diaries was high, there was substantial heterogeneity in study objectives, implementation strategies, and follow-up methods. The authors recommend multicenter studies to evaluate the effects on PICS-F and advocate for standardized implementation of narrative diaries in neonatal intensive care.
Sorrentino G, Thekkan KR, Genna C, Aite L, Ragni A, Bevilacqua F, Dall'Oglio I, Roberti M, Tiozzo E, Gawronski O. The implementation and impact of narrative diaries in neonatal intensive care units: A scoping review. Nurs Crit Care. 2025 Mar;30(2):e13281. Link
Family Care Diary
A Family Care Diary was introduced in this single-center study to systematically incorporate family feedback on their experiences in the pediatric intensive care unit (PICU) into patient care. The diary allowed families to record information about treatment and the care team, as well as their questions and thoughts.
In an evaluation involving 306 families, three-quarters of respondents rated the intervention as highly beneficial. The study indicates that most families found the diary helpful for communication with the PICU team. Additionally, the diary provided valuable feedback to the medical staff, highlighting both areas of excellence (e.g., quality of nursing care) and areas for improvement (e.g., communication processes).
Tcharmtchi, J., Coss‐Bu, J. A., & Tcharmtchi, M. H. (2024). Enhancing family experience in the paediatric intensive care unit through the adoption of the family care journal: A single‐center study. Nursing in Critical Care. Link
Publication in Apotheken Umschau
Journalist N. Himmer has published an article on ICU diaries in Apotheken Umschau, a medical journal in plain language, available for free in every pharmacy in Germany. While this may seem trivial at first, Apotheken Umschau is Germany’s largest health magazine, with a circulation of 9 million copies, playing a key role in public health education.
An article on ICU diaries in such a widely read publication could increase awareness and encourage more families of ICU patients to adopt this simple yet effective intervention. Ideally, this will also promote the introduction of diaries in ICUs where they are not yet in use. We sincerely thank Ms. Himmer for her valuable contribution! Link
RELATED STUDIES
Some titles were sourced from the @ICURehab Newsletter by Dale M. Needham and Critical Care Reviews by Rob Mac Sweeney. These were edited and supplemented with findings from our own searches.
SCCM Guideline on Family-Centered Care: The Society of Critical Care Medicine (SCCM) has released an updated guideline on family-centered care, presenting 17 recommendations:
- Strong recommendation (low-quality evidence): Liberalized visiting hours.
- Conditional recommendations (low to very low-quality evidence): Integration of family members into patient care, presence during resuscitation, provision of information to relatives, involvement in decision-making, use of ICU diaries, and screening for the needs and risks of family members.
- Practice recommendations: Availability of waiting and recovery areas and equitable support for families.
You can find the guideline and a tool for implementation here: Link
Families & Virtual Reality (VR): A randomized controlled trial (RCT) involving 180 family members examined whether providing ICU-related information via VR headsets compared to standard care had any benefits in reducing anxiety, depression, or PTSD after six months. The study found no significant differences between the groups. Drop et al (2025) from the Netherlands Link
Delirium Prevention Through Family Involvement: A meta-analysis of 11 RCTs including 3,113 ICU patients compared family-integrated care to standard care regarding delirium outcomes. Family involvement led to a 50% reduction in delirium incidence, a shorter delirium duration (by approximately two days), and a 1.5-day reduction in ICU length of stay.
The most effective approach was direct family participation in patient care (RR 0.37), followed by visitation and companionship (RR 0.56) and indirect involvement (RR 0.77). Li et al. (2025) Link
Concepts for Family Integration: A systematic review of 14 studies identified four key concepts for integrating families into ICU care: dignity and respect, participation in patient care, information exchange, and collaboration. These concepts were generally associated with increased family satisfaction and a reduction in anxiety and depression. However, further research is needed to refine and differentiate their impact. Joo et al (2024) Link
Emotional Limbo: The Needs of Families: An analysis of 124 studies on family needs identified a central theme: emotional limbo and extreme moments. Key supportive measures include responding to families' needs, facilitating reciprocal communication, and fostering a compassionate and humane atmosphere in the ICU. Gunnlaugsdottir et al (2025) Link
Impact-ICU: A study on post-ICU follow-up care is being planned in Canada. The intervention includes ICU diaries, informational materials on the post-ICU period, and follow-up meetings at one and three months. The control group will receive standard care. The study aims to evaluate feasibility, recruitment, adherence, and other key parameters. Jawa et al. (2025) from Canada. Link
Core Outcome Set: In this Delphi study, a multistage survey involving healthcare professionals, patients, and relatives, six key outcomes were identified for ICU survivors: survival, freedom from life-sustaining measures, absence of delirium, hospital discharge, health-related quality of life, and cognitive function. Kjaer et al. (2025) Link
Family Support: Among 196 family members of ICU patients, the Caregiver Pathway—which includes a meeting with intensive care staff, a support card, a follow-up phone call after discharge, and post-ICU follow-up within three months—was associated with a reduction in PICS-F (PTSD, anxiety, and depression) compared to standard care in families of ICU survivors. RCT von Watland et al (2024) from Norway Link
Personalized Music: According to interviews with 14 critically ill patients, listening to personalized music was associated with several benefits, including restoring awareness, maintaining cognitive function, humanizing the hospital experience, fostering connection, improving psychological well-being, and addressing the challenges of silence. Menza et al (2024) from the USA Link
Cognitive Rehabilitation: An umbrella review on cognitive rehabilitation during and after intensive care analyzed 13 meta-syntheses encompassing 29 original studies. Various multicomponent interventions combining cognitive and physical activities were identified, including peer support groups, exercise manuals, relaxation techniques, Sudoku, and television-based interventions. Due to the heterogeneity of the studies, no specific recommendations could be made regarding intervention type, timing, duration, or target populations. Holm et al. (2024) Link
Delirium & Family: An intervention using a family member’s voice for re-orientation, prevention, and treatment of delirium in ICU patients was found to be feasible and was positively received by patients, relatives, and healthcare staff. Johnson et al. (2024) from Australia Link
Culturally Sensitive Communication: A Delphi study developed 13 recommendations for culturally sensitive communication with families of patients at the end of life. Key aspects include supporting families in performing cultural, spiritual, and religious rituals and customs, promoting family involvement in discussions on treatment limitations, and ensuring healthcare professionals have access to training in culturally sensitive communication. Brooks et al (2025) from Australia Link
PICS: The U.S. journal Critical Care Clinics has published a special issue on Post-Intensive Care Syndrome (PICS), PICS-F (family impact), and PICS-p (pediatric impact). This edition includes articles on physical, psychological, cognitive, social, and financial aspects, as well as topics such as sedation, the A2F Bundle, rehabilitation, follow-up care, and health equity. Link
Pediatric Studies
Supporting Children Through Farewell Processes: Children are welcome as visitors in intensive care units. When visiting a dying patient for the last time, this experience can help them understand the situation, but it also requires professional guidance and support. Rowland et al (2025) Link
End-of-life: End-of-life decisions in pediatric intensive care and neonatology are guided by ethical principles. A systematic review summarizing nine papers analyzed existing guidelines and recommendations for such situations. Twelve ethical principles were identified, including singularity, dignity, proportionality, purposefulness, non-maleficence, justice (resource allocation), professional duty, beneficence, truthfulness, autonomy, the right to optimal treatment, and the right to self-determined life. Beneficence was cited as the most frequently emphasized principle. Špoljar et al (2025) Link
Follow-Up Care for Children: What does follow-up care look like for children who have been treated in an ICU? A review of 68 studies examining follow-up assessments found that post-ICU care concepts vary widely in terms of timing, involved healthcare professionals, and assessment methods. The most common follow-up time points were at discharge, 3, 6, and 12 months, with only 20% of studies reporting follow-ups beyond one year. One-third of the studies focused on quality of life and neurological parameters, while only 7% assessed the emotional burden on parents. The findings underscore the need for standardized follow-up care, particularly to address Post-Intensive Care Syndrome in children (PICS-p). Micaëlli et al. (2025). Link
The Way Home – A Psychoanalytic Case Report: This case report from Brazil describes the psychological support provided to a family (mother, father, and three-year-old son) with premature twins, from their admission to the neonatal intensive care unit (NICU) until approximately six weeks after discharge. The focus is particularly on the mother's experience, the development of her bond with the children, and the role of the NICU in this process. The authors adopt a psychoanalytic approach, characterized by unfiltered documentation of subjective impressions and recurrent use of visual analogies. A distinctive feature of the study is the use of clinical diaries, which serve as a tool to capture immediate perceptions and form the basis of the case description. Giguer, F et al (2025) Link
Did We Miss a Study?
We cannot review and summarize every study. If we have overlooked an important one, please send us a short summary and a reference via email, and we will gladly include it in the newsletter!
Stay healthy!
Chu-Won, Kristin, Manuel, Maria & Peter
Dr. Chu-Won Sim, M.Sc. – Psychologist, Department of Pediatric Cardiology, German Heart Center of Charité (DHZC), Berlin, Germany
Kristin Gabriel – Media Scientist, Art Historian, and Yoga Instructor, Berlin
Manuel Köpper, M.Sc. – Psychologist, Pediatric Intensive Care Unit, University Hospital Tübingen, Germany
Maria Brauchle, GKP – Nursing School Vorarlberg, Feldkirch, Austria
PD Dr. Peter Nydahl, RN BScN MScN – Nursing Research, University Hospital Schleswig-Holstein, Kiel, Germany