Newsletter June 2025
28/05/25 09:14 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
DIARIES ONLINE
WEBINARS:
Internationale Conference about ICU Diaries
Online, Englisch with translated subtitles, no recording.
North/South America: CST 7:00 a.m.
UK: BST 1:00 p.m.
Central Europe: CEST 2:00 p.m.
Australia: AEST 9 p.m.
June 10th: ICU Diaries Link
June 17th: ICU Diaries in special settings Link
June 24th: Digital ICU Diaries? Link
July 1st: Lived experiences of diaries of patients and relatives Link
July 8th: PICS and After care/follow-up Link
A detailed program is here Conference 2025
Organized by Bev Ewens, Australia, L. Gallie, UK, C. Jones, UK, L. Karnatovskaia, USA, and P Nydahl, Germany
Safe the Date: 14th Johns Hopkins Critical Care Rehabilitation Conference
Date: November 6-7, 2025
Register now: ICURehabNetwork.org
Description: The Conference builds on last year’s Conference with nearly 400 attendees from around the world. This year’s Conference focuses on the latest update from the past year, offering all-new, evidence-based content to advance early mobility and rehabilitation in adult ICUs.
This two-day conference brings together 16 expert multi-disciplinary speakers. Attendees will have access to 5 interactive workshops and 2 “Meet the Expert” lunch-and-learn sessions, all aimed at fostering collaboration and improving ICU and hospital-wide care. Moreover, there are designated networking sessions for PT, OT, SLP, and Nursing registrants.
This Conference offers a truly unique learning experience, exemplifying and promoting the kind of collaboration needed for successful early mobility/rehabilitation programs in adult ICUs!
PODCAST
Kids visitations in the ICU. Ten recommendations for child-friendly visiting policies in critical care. ESICM Podcast with M. Brauchle & P. Nydahl Link
ICU DIARIES
Intensive Care Diaries in Guidelines
Intensive care diaries are now recommended in guidelines. In at least three guidelines, they are conditionally recommended based on weak evidence:
The Significance of ICU Diaries for the Families of Critically Ill Patients
The admission of a loved one to an intensive care unit represents an exceptional and distressing situation for family members, often accompanied by fear, helplessness, and emotional strain. Against this background, the research question arose as to what experiences family members have with ICU diaries and what meanings they attribute to them. Bosco et al. (2025) conducted a qualitative study using narrative analysis, based on diary entries from 16 relatives of critically ill patients. The analysis of 13 diaries revealed three central themes: (1) The significance of time, particularly through memories of the past and hopes for the future; Quote: “Can you remember how you used to hold my hand and comfort me?”; (2) The family context, with subthemes such as emotional closeness, fear of suffering, spirituality, the patient’s role in family life, and the connection to the outside world; Quote: “And as I write this, I feel like I’m talking to you, and I know that when you wake up again, you’ll be able to read everything.”; (3) The diary’s usefulness as a communication tool and for improving understanding of the care and treatment process; Quote: “The diary helps me understand what’s happening when I’m not there.” For relatives, the ICU diary is a complex but very helpful intervention. The study has limitations, as it was confined to a single geographical region and conducted solely from the perspective of family members. Bosco et al. conclude that diaries offer valuable support for emotional processing and can strengthen the relationship between relatives and the care team. For intensive care nursing in Germany, the study underscores the importance of diaries in promoting empathetic, family-centred care.
Bosco V, Mercuri C, Nocerino R, Czapla M, Uchmanowicz I, Mazzotta R, Giordano V, Simeone S. Family members' experiences with intensive care unit diaries. BMC Anesthesiol. 2025 Apr 24;25(1):210. doi: 10.1186/s12871-025-03083-1 Link
Experiencing Life as a Newborn
Care provided to newborns in a neonatal intensive care unit is life-saving – yet it also imposes considerable stress on the infant. Against this background, the research question was how hospitalised infants experience their time in the neonatal intensive care unit (NICU). Duffy et al. (2025) addressed this question through a qualitative study using an innovative "360-degree phenomenology" approach.
The 360-degree phenomenology brings together different perspectives – those of the infant, parents, professionals, and researchers – to form a holistic picture. At its core is the direct observation of the infant and their reactions to caregiving actions and their environment, complemented by reflective input from the adults involved in their care. This approach allows for a rich description of the infant's lived experience, without reducing it to physiological data alone.
Seven case studies were analysed, based on observation notes, diary entries, Newborn Behavioural Observation (NBO), and interviews with parents and medical staff. The findings identified four key themes:
1. The tension between fear and safety,
2. The multitude of distressing medical procedures,
3. The emotional challenge for the infant, and
4. “Moments of connection” – meaningful interactions with caregivers.
Diaries proved to be an important tool for capturing the infants’ perspective, documenting their development, and making emotional bonds visible. The study’s limitations include the small sample size, the exclusive focus on full-term infants, and the inevitable dependence on interpretation.
Nevertheless, the authors conclude that consciously perceiving and documenting the infant’s perspective can open up new approaches to individualised, developmentally supportive intensive care. For intensive care nursing in Germany, the study compellingly illustrates how diaries can help in recognising newborns as active participants in their own care and in emotionally grounding nursing practice.
Duffy N, Hickey L, Treyvaud K, Delany C. A study of the infant's lived experience of neonatal intensive care. Early Hum Dev. 2025 Jun;205:106254. doi: 10.1016/j.earlhumdev.2025.106254 Link
PICU Diaries
Intensive care diaries are increasingly being used in paediatric intensive care units (PICU) as a potentially important tool to support children, families, and healthcare professionals. Lynch et al. investigated the research question: What is the impact of PICU diaries on children, their families, and healthcare staff? The authors conducted a systematic literature search in the databases CINAHL, Medline, and EMBASE, as well as Google Scholar, to identify studies from 2016 to 2024. A total of 13 articles were included, covering quantitative, qualitative, mixed methods, prospective studies, and quality improvement projects. The results show that PICU diaries are diverse in structure, mostly paper-based, and are generally positively received. They help parents express emotions, understand the hospital course, and maintain an emotional connection with their child. Children benefit by better understanding their illness trajectory, even though they often remember little. For healthcare professionals, diaries offer opportunities for reflection and communication, though concerns remain about legal and professional implications. Limitations include the small number and heterogeneity of studies, the lack of standardized outcomes (e.g., regarding PTSD), and a strong European focus. Open research questions relate to psychological effects, use in bereavement situations, and the role of digital diary formats. This work highlights the importance of diaries as a low-threshold intervention to improve the care of critically ill children and their parents.
Lynch P, Latour JM, Endacott, R. Impact of patient diaries on children, families, and healthcare professionals in paediatric intensive care settings: A scoping review. Intensive and Critical Care Nursing 89 (2025), 104087, Link
RELATED STUDIES
Some titles were taken from the newsletters of @ICURehab Newsletter by Dale M. Needham and Critical Care Reviews by Rob Mac Sweeney, and of course our own searches.
Agitation Agitation is characterised by "excessive motor activity, emotional tension, cognitive impairment, disruption of care, and often accompanied by aggressive behaviour and changes in vital signs". Concept paper by Adams et al. (2025) Link
ICUAW & Obesity: Contrary to previous hypotheses, this observational study (n=106) found that obese individuals were at higher risk of severe muscle wasting during the early phase of their intensive care stay compared to those with low body fat. Koga et al., Japan (2025) Link
Sepsis: One year after sepsis, patient outcomes vary greatly in terms of employment, rehospitalisation, quality of life, mortality, and independence. Liu et al., Japan (2025) Link
PICS (Post-Intensive Care Syndrome): In a cohort of 148 ICU survivors, the occurrence of PICS correlated with caregiver burden at specific time points (after 3 and 12 months). However, no sustained reciprocal long-term relationship between these two factors was found. Ahn et al., USA (2025) Link
Sexuality: Up to 40% of ICU survivors report newly developed sexual dysfunctions – yet no one talks to them about it. Editorial by Bourke et al. (2025) Link
Delirium & PTSD: Delirium may also contribute to the development of post-traumatic stress disorder (PTSD), potentially leading to significant long-term consequences. Review article by Hertrich & Grundei (2025)Link
Thirst Management: In a randomised controlled trial involving 84 ICU patients, a spray of 5 ml cold water (2–6 °C) was found to be most effective in relieving thirst, compared to a 1.6 ml cold water spray (2–6 °C) and 1.6 ml of room temperature water (20–26 °C) administered by spoon. Yuan et al., China (2025) Link
Family Involvement: The integration of families into early rehabilitation and mobilisation processes can be evaluated in advance using a specific questionnaire. Mukpradab et al., Australia (2025)Link
Family Integration: A new assessment tool, FAME, has been developed to explore family integration from the perspective of the family itself. Kifell et al., Canada (2025) Link
Restraints: Does the use of physical restraints in intensive care lead to poorer long-term psychological outcomes? The situation is complex, difficult to assess, and remains unclear. However, further research is needed. Commentary by Benbenishty et al. (2025) Link
Sociodemographic Factors: A systematic review identified various sociodemographic factors that significantly influence the development of Post-Intensive Care Syndrome (PICS): education, employment status, social environment, income, ethnicity, marital status, neighbourhood, insurance status, parenthood, non-English language (!), being a physician oneself, and religion. Li et al. (2025) Link
Wealth & Mortality: In general, higher socioeconomic status is associated with lower mortality. In the United States, this link is much more pronounced than in Europe – meaning that the poorer population there experiences significantly higher mortality rates. Machado et al. (2025) Link
Visitor Expectations: In a survey of 224 visitors to ICU patients, respondents were asked what mattered most to them regarding (a) the hospital, (b) the waiting area, and (c) the ICU rooms. The most common answers were: (a) reduced parking fees, (b) 24/7 visiting hours, and (c) a chair next to the patient’s bed. Mehta et al., Canada (2025). Link
Communication: Patients with Post-Intensive Care Syndrome (PICS) and their families should be empathetically informed about the post-discharge phase and potential risks already during the ICU stay. This early communication supports the development of sufficient health literacy. Rolfsen et al. (2025) Link
Sleep Quality: Recovery of sleep quality among 196 ICU patients can vary greatly, even up to two years after discharge, and is closely linked to cognitive health. Henriquez-Beltran et al., Spain (2025) Link
Recovery After Sepsis: In a one-year health status analysis of 220 ICU patients following sepsis, four distinct recovery types were identified: Group 1 (28%) showed no symptoms of PICS after one year, Group 2 (25%) experienced mild physical and cognitive problems, Group 3 (24%) had moderate impairments, Group 4 (23%) suffered from severe issues across all PICS domains and had lower survival rates. Cohort study by Liu et al., Japan (2025) Link
PEDIATRIC STUDIES
Parents: In a study of 224 children admitted to a paediatric intensive care unit, 44% experienced delirium. The presence of parents was associated with a reduced incidence of delirium on the same day or the following day. Smith et al., USA (2025) Link
Conflicts on the ward: Disagreements between the treatment team and the family of the child can occur more frequently on a PICU. This study is the first to investigate which strategies are used when conflicts happen. Leading physicians and nurses were interviewed and previously used conflict management approaches were collected. The authors from the U.S. recommend a standardized procedure to prevent conflicts from occurring as well as to manage them, when they have been arisen. Olszewski et al (2025) Link
PICS-p focussing the brain development of infants: This narrative review from Canada focuses on infants and the (possible) effects of an PICU stay on cognitive development. The period from birth to 2 years of age is a time of extremely rapid brain development. Similarities are drawn between traumatic events in early childhood and PICS-p outcomes and risk factors. Interventions are then presented to support „brain-directed“care that starts in the intensive care unit. Joffe et al (2025) Link
Diagnostic uncertainties on the PICU: In this multicenter, retrospective cohort study from the U.S., medical records were reviewed in a structured manner to determine the prevalence and factors of diagnostic uncertainty in critically ill children in the PICU. Diagnostic uncertainty was found in a quarter of the children and was significantly associated with greater severity of illness, diagnostic inconsistencies between physicians and a neurological primary diagnosis.
Cifra et al (2025) Link
Photo-narrative: Families with a severely neurologically impaired child on a PICU are confronted with assumptions about their child. This qualitative study from the U.S. introduced a photo narrative in which parents hung representative photos of their children in everyday life visibly at the child's bedside. The aim of the pictures was to engage in an exchange with the treatment team. Based on feedback from both sides, this intervention was adapted so that it could be implemented in the future. (See the article for generous instructions on how to do this) Findings included that photos increased the chance of communicating a family's values, contextualizing the child's health status, and improving the relationship between the child and the treatment team. Bogetz et al (2025) Link
Disturbed sleep: Sleep disorders have consequences for critically ill children. This study from Norway looked at the sleep quality of children on PICU and the factors that affect sleep. Sleep measurements were carried out on 21 children using actigraphy, noise measurements and sleep diaries. The median total 24-hour sleep time was 10.5 hours. The children had highly fragmented sleep. The median equivalent continuous sound level was 55.79 dBA. Single rooms had significantly higher equivalent continuous sound levels than shared rooms (p < 0.001) (due to higher noise peaks). The most frequently documented reasons for waking up were medical staff and interventions. Reducing these disturbances therefore has an effect on the quality of sleep. Nenningsland et al (2025) Link
Treatment of maltreated children Caregiver in pediatric intensive care units face challenges in caring for abused children and adolescents. this qualitative study from Taiwan identified three main themes: (1) unstable nurse-patient relationships, (2) perceived lack of competence in dealing with child maltreatment, and (3) challenges in collaborating in multidisciplinary teams.
Huang 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
DIARIES ONLINE
WEBINARS:
Internationale Conference about ICU Diaries
Online, Englisch with translated subtitles, no recording.
North/South America: CST 7:00 a.m.
UK: BST 1:00 p.m.
Central Europe: CEST 2:00 p.m.
Australia: AEST 9 p.m.
June 10th: ICU Diaries Link
June 17th: ICU Diaries in special settings Link
June 24th: Digital ICU Diaries? Link
July 1st: Lived experiences of diaries of patients and relatives Link
July 8th: PICS and After care/follow-up Link
A detailed program is here Conference 2025
Organized by Bev Ewens, Australia, L. Gallie, UK, C. Jones, UK, L. Karnatovskaia, USA, and P Nydahl, Germany
Safe the Date: 14th Johns Hopkins Critical Care Rehabilitation Conference
Date: November 6-7, 2025
Register now: ICURehabNetwork.org
Description: The Conference builds on last year’s Conference with nearly 400 attendees from around the world. This year’s Conference focuses on the latest update from the past year, offering all-new, evidence-based content to advance early mobility and rehabilitation in adult ICUs.
This two-day conference brings together 16 expert multi-disciplinary speakers. Attendees will have access to 5 interactive workshops and 2 “Meet the Expert” lunch-and-learn sessions, all aimed at fostering collaboration and improving ICU and hospital-wide care. Moreover, there are designated networking sessions for PT, OT, SLP, and Nursing registrants.
This Conference offers a truly unique learning experience, exemplifying and promoting the kind of collaboration needed for successful early mobility/rehabilitation programs in adult ICUs!
PODCAST
Kids visitations in the ICU. Ten recommendations for child-friendly visiting policies in critical care. ESICM Podcast with M. Brauchle & P. Nydahl Link
ICU DIARIES
Intensive Care Diaries in Guidelines
Intensive care diaries are now recommended in guidelines. In at least three guidelines, they are conditionally recommended based on weak evidence:
- Renner C, Jeitziner MM, Albert M, Brinkmann S, Diserens K, Dzialowski I, Heidler MD, Lück M, Nusser-Müller-Busch R, Sandor PS, Schäfer A, Scheffler B, Wallesch C, Zimmermann G, Nydahl P. Guideline on multimodal rehabilitation for patients with post-intensive care syndrome. Crit Care. 2023 Jul 31;27(1):30: Link
- Haute Autorite de Sante (2023). Diagnosis and management of adults with post-intensive care syndrome (PICS) and their relatives. Link
- Hwang DY, Oczkowski SJW, Lewis K, Birriel B, Downar J, Farrier CE, Fiest KM, Gerritsen RT, Hart J, Hartog CS, Heras-La Calle G, Hope AA, Jennerich AL, Kentish-Barnes N, Kleinpell R, Kross EK, Marshall AP, Nydahl P, Peters T, Rosa RG, Scruth E, Sederstrom N, Stollings JL, Turnbull AE, Valley TS, Netzer G, Aslakson RA, Hopkins RO. Society of Critical Care Medicine Guidelines on Family-Centered Care for Adult ICUs: 2024. Crit Care Med. 2025 Feb 1;53(2):e459-e464 Link
The Significance of ICU Diaries for the Families of Critically Ill Patients
The admission of a loved one to an intensive care unit represents an exceptional and distressing situation for family members, often accompanied by fear, helplessness, and emotional strain. Against this background, the research question arose as to what experiences family members have with ICU diaries and what meanings they attribute to them. Bosco et al. (2025) conducted a qualitative study using narrative analysis, based on diary entries from 16 relatives of critically ill patients. The analysis of 13 diaries revealed three central themes: (1) The significance of time, particularly through memories of the past and hopes for the future; Quote: “Can you remember how you used to hold my hand and comfort me?”; (2) The family context, with subthemes such as emotional closeness, fear of suffering, spirituality, the patient’s role in family life, and the connection to the outside world; Quote: “And as I write this, I feel like I’m talking to you, and I know that when you wake up again, you’ll be able to read everything.”; (3) The diary’s usefulness as a communication tool and for improving understanding of the care and treatment process; Quote: “The diary helps me understand what’s happening when I’m not there.” For relatives, the ICU diary is a complex but very helpful intervention. The study has limitations, as it was confined to a single geographical region and conducted solely from the perspective of family members. Bosco et al. conclude that diaries offer valuable support for emotional processing and can strengthen the relationship between relatives and the care team. For intensive care nursing in Germany, the study underscores the importance of diaries in promoting empathetic, family-centred care.
Bosco V, Mercuri C, Nocerino R, Czapla M, Uchmanowicz I, Mazzotta R, Giordano V, Simeone S. Family members' experiences with intensive care unit diaries. BMC Anesthesiol. 2025 Apr 24;25(1):210. doi: 10.1186/s12871-025-03083-1 Link
Experiencing Life as a Newborn
Care provided to newborns in a neonatal intensive care unit is life-saving – yet it also imposes considerable stress on the infant. Against this background, the research question was how hospitalised infants experience their time in the neonatal intensive care unit (NICU). Duffy et al. (2025) addressed this question through a qualitative study using an innovative "360-degree phenomenology" approach.
The 360-degree phenomenology brings together different perspectives – those of the infant, parents, professionals, and researchers – to form a holistic picture. At its core is the direct observation of the infant and their reactions to caregiving actions and their environment, complemented by reflective input from the adults involved in their care. This approach allows for a rich description of the infant's lived experience, without reducing it to physiological data alone.
Seven case studies were analysed, based on observation notes, diary entries, Newborn Behavioural Observation (NBO), and interviews with parents and medical staff. The findings identified four key themes:
1. The tension between fear and safety,
2. The multitude of distressing medical procedures,
3. The emotional challenge for the infant, and
4. “Moments of connection” – meaningful interactions with caregivers.
Diaries proved to be an important tool for capturing the infants’ perspective, documenting their development, and making emotional bonds visible. The study’s limitations include the small sample size, the exclusive focus on full-term infants, and the inevitable dependence on interpretation.
Nevertheless, the authors conclude that consciously perceiving and documenting the infant’s perspective can open up new approaches to individualised, developmentally supportive intensive care. For intensive care nursing in Germany, the study compellingly illustrates how diaries can help in recognising newborns as active participants in their own care and in emotionally grounding nursing practice.
Duffy N, Hickey L, Treyvaud K, Delany C. A study of the infant's lived experience of neonatal intensive care. Early Hum Dev. 2025 Jun;205:106254. doi: 10.1016/j.earlhumdev.2025.106254 Link
PICU Diaries
Intensive care diaries are increasingly being used in paediatric intensive care units (PICU) as a potentially important tool to support children, families, and healthcare professionals. Lynch et al. investigated the research question: What is the impact of PICU diaries on children, their families, and healthcare staff? The authors conducted a systematic literature search in the databases CINAHL, Medline, and EMBASE, as well as Google Scholar, to identify studies from 2016 to 2024. A total of 13 articles were included, covering quantitative, qualitative, mixed methods, prospective studies, and quality improvement projects. The results show that PICU diaries are diverse in structure, mostly paper-based, and are generally positively received. They help parents express emotions, understand the hospital course, and maintain an emotional connection with their child. Children benefit by better understanding their illness trajectory, even though they often remember little. For healthcare professionals, diaries offer opportunities for reflection and communication, though concerns remain about legal and professional implications. Limitations include the small number and heterogeneity of studies, the lack of standardized outcomes (e.g., regarding PTSD), and a strong European focus. Open research questions relate to psychological effects, use in bereavement situations, and the role of digital diary formats. This work highlights the importance of diaries as a low-threshold intervention to improve the care of critically ill children and their parents.
Lynch P, Latour JM, Endacott, R. Impact of patient diaries on children, families, and healthcare professionals in paediatric intensive care settings: A scoping review. Intensive and Critical Care Nursing 89 (2025), 104087, Link
RELATED STUDIES
Some titles were taken from the newsletters of @ICURehab Newsletter by Dale M. Needham and Critical Care Reviews by Rob Mac Sweeney, and of course our own searches.
Agitation Agitation is characterised by "excessive motor activity, emotional tension, cognitive impairment, disruption of care, and often accompanied by aggressive behaviour and changes in vital signs". Concept paper by Adams et al. (2025) Link
ICUAW & Obesity: Contrary to previous hypotheses, this observational study (n=106) found that obese individuals were at higher risk of severe muscle wasting during the early phase of their intensive care stay compared to those with low body fat. Koga et al., Japan (2025) Link
Sepsis: One year after sepsis, patient outcomes vary greatly in terms of employment, rehospitalisation, quality of life, mortality, and independence. Liu et al., Japan (2025) Link
PICS (Post-Intensive Care Syndrome): In a cohort of 148 ICU survivors, the occurrence of PICS correlated with caregiver burden at specific time points (after 3 and 12 months). However, no sustained reciprocal long-term relationship between these two factors was found. Ahn et al., USA (2025) Link
Sexuality: Up to 40% of ICU survivors report newly developed sexual dysfunctions – yet no one talks to them about it. Editorial by Bourke et al. (2025) Link
Delirium & PTSD: Delirium may also contribute to the development of post-traumatic stress disorder (PTSD), potentially leading to significant long-term consequences. Review article by Hertrich & Grundei (2025)Link
Thirst Management: In a randomised controlled trial involving 84 ICU patients, a spray of 5 ml cold water (2–6 °C) was found to be most effective in relieving thirst, compared to a 1.6 ml cold water spray (2–6 °C) and 1.6 ml of room temperature water (20–26 °C) administered by spoon. Yuan et al., China (2025) Link
Family Involvement: The integration of families into early rehabilitation and mobilisation processes can be evaluated in advance using a specific questionnaire. Mukpradab et al., Australia (2025)Link
Family Integration: A new assessment tool, FAME, has been developed to explore family integration from the perspective of the family itself. Kifell et al., Canada (2025) Link
Restraints: Does the use of physical restraints in intensive care lead to poorer long-term psychological outcomes? The situation is complex, difficult to assess, and remains unclear. However, further research is needed. Commentary by Benbenishty et al. (2025) Link
Sociodemographic Factors: A systematic review identified various sociodemographic factors that significantly influence the development of Post-Intensive Care Syndrome (PICS): education, employment status, social environment, income, ethnicity, marital status, neighbourhood, insurance status, parenthood, non-English language (!), being a physician oneself, and religion. Li et al. (2025) Link
Wealth & Mortality: In general, higher socioeconomic status is associated with lower mortality. In the United States, this link is much more pronounced than in Europe – meaning that the poorer population there experiences significantly higher mortality rates. Machado et al. (2025) Link
Visitor Expectations: In a survey of 224 visitors to ICU patients, respondents were asked what mattered most to them regarding (a) the hospital, (b) the waiting area, and (c) the ICU rooms. The most common answers were: (a) reduced parking fees, (b) 24/7 visiting hours, and (c) a chair next to the patient’s bed. Mehta et al., Canada (2025). Link
Communication: Patients with Post-Intensive Care Syndrome (PICS) and their families should be empathetically informed about the post-discharge phase and potential risks already during the ICU stay. This early communication supports the development of sufficient health literacy. Rolfsen et al. (2025) Link
Sleep Quality: Recovery of sleep quality among 196 ICU patients can vary greatly, even up to two years after discharge, and is closely linked to cognitive health. Henriquez-Beltran et al., Spain (2025) Link
Recovery After Sepsis: In a one-year health status analysis of 220 ICU patients following sepsis, four distinct recovery types were identified: Group 1 (28%) showed no symptoms of PICS after one year, Group 2 (25%) experienced mild physical and cognitive problems, Group 3 (24%) had moderate impairments, Group 4 (23%) suffered from severe issues across all PICS domains and had lower survival rates. Cohort study by Liu et al., Japan (2025) Link
PEDIATRIC STUDIES
Parents: In a study of 224 children admitted to a paediatric intensive care unit, 44% experienced delirium. The presence of parents was associated with a reduced incidence of delirium on the same day or the following day. Smith et al., USA (2025) Link
Conflicts on the ward: Disagreements between the treatment team and the family of the child can occur more frequently on a PICU. This study is the first to investigate which strategies are used when conflicts happen. Leading physicians and nurses were interviewed and previously used conflict management approaches were collected. The authors from the U.S. recommend a standardized procedure to prevent conflicts from occurring as well as to manage them, when they have been arisen. Olszewski et al (2025) Link
PICS-p focussing the brain development of infants: This narrative review from Canada focuses on infants and the (possible) effects of an PICU stay on cognitive development. The period from birth to 2 years of age is a time of extremely rapid brain development. Similarities are drawn between traumatic events in early childhood and PICS-p outcomes and risk factors. Interventions are then presented to support „brain-directed“care that starts in the intensive care unit. Joffe et al (2025) Link
Diagnostic uncertainties on the PICU: In this multicenter, retrospective cohort study from the U.S., medical records were reviewed in a structured manner to determine the prevalence and factors of diagnostic uncertainty in critically ill children in the PICU. Diagnostic uncertainty was found in a quarter of the children and was significantly associated with greater severity of illness, diagnostic inconsistencies between physicians and a neurological primary diagnosis.
Cifra et al (2025) Link
Photo-narrative: Families with a severely neurologically impaired child on a PICU are confronted with assumptions about their child. This qualitative study from the U.S. introduced a photo narrative in which parents hung representative photos of their children in everyday life visibly at the child's bedside. The aim of the pictures was to engage in an exchange with the treatment team. Based on feedback from both sides, this intervention was adapted so that it could be implemented in the future. (See the article for generous instructions on how to do this) Findings included that photos increased the chance of communicating a family's values, contextualizing the child's health status, and improving the relationship between the child and the treatment team. Bogetz et al (2025) Link
Disturbed sleep: Sleep disorders have consequences for critically ill children. This study from Norway looked at the sleep quality of children on PICU and the factors that affect sleep. Sleep measurements were carried out on 21 children using actigraphy, noise measurements and sleep diaries. The median total 24-hour sleep time was 10.5 hours. The children had highly fragmented sleep. The median equivalent continuous sound level was 55.79 dBA. Single rooms had significantly higher equivalent continuous sound levels than shared rooms (p < 0.001) (due to higher noise peaks). The most frequently documented reasons for waking up were medical staff and interventions. Reducing these disturbances therefore has an effect on the quality of sleep. Nenningsland et al (2025) Link
Treatment of maltreated children Caregiver in pediatric intensive care units face challenges in caring for abused children and adolescents. this qualitative study from Taiwan identified three main themes: (1) unstable nurse-patient relationships, (2) perceived lack of competence in dealing with child maltreatment, and (3) challenges in collaborating in multidisciplinary teams.
Huang 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