This pilot study evaluated a brief parent journaling program in the neonatal intensive care unit (NICU).
Hundred NICU parents were randomized to a control group (no journal) or an intervention group (journal provided). Parents reported pre- and post-intervention anxiety and depression symptoms using the hospital anxiety and depression scale (HADS) and qualitative journal use data. The analysis included Student’s paired two-tailed t-test and two-way ANOVA. This study was registered with clinicaltrials.gov on April 1, 2020, NCT04331925.
At baseline, clinically significant anxiety was more prevalent than depression (66% vs. 23%). Post-intervention scores were best predicted by baseline scores. Relative to controls, intervention group parents experienced a decrease in anxiety from baseline (t = −1.983, p = 0.056). The same effect was not seen for depression. Most intervention group parents used the journal and provided positive feedback.
Journal use rates and positive feedback support the acceptability of a NICU journaling program.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
Davidson JE, Aslakson RA, Long AC, Puntillo KA, Kross EK, Hart J, et al. Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Crit Care Med. 2017;45:103–22.
Garrouste-Orgeas M, Perier A, Mouricou P, Gregoire C, Bruel C, Brochon C, et al. Writing in and reading ICU diaries: qualitative study of families’ experience in the ICU. PLoS ONE. 2014;9:e110146.
Jones C, Backman C, Griffiths RD. Intensive care diaries and relatives’ symptoms of posttraumatic stress disorder after critical illness: a pilot study. Am J Crit Care. 2012;21:172–6.
Davis L, Edwards H, Mohay H, Wollin J. The impact of very premature birth on the psychological health of mothers. Early Hum Dev. 2003;73:61–70.
American Academy of Pediatrics Committee on Hospital Care. Family-centered care and the pediatrician’s role. Pediatrics. 2003;112:691–6.
Macnab AJ, Beckett LY, Park CC, Sheckter L. Journal writing as a social support strategy for parents of premature infants: a pilot study. Patient Educ Couns. 1998;33:149–59.
Barry LM, Singer GH. Reducing maternal psychological distress after the NICU experience through journal writing. J Early Interv. 2001;24:287–97.
Greene MM, Rossman B, Meier P, Patra K. Elevated maternal anxiety in the NICU predicts worse fine motor outcome in VLBW infants. Early Hum Dev. 2018;116:33–9.
Dryer K, Williamson RAP, Hargreaves DS, Rosen R, Deeny SR. Associations between parental mental health and other family factors and healthcare utilization among children and young people: a retrospective, cross-sectional study of linked healthcare data. BMJ Paediatr. 2018;2:e000266.
Turney K. Maternal depression and childhood health inequalities. J Health Soc Behav. 2011;52:314–32.
Crawford JR, Henry JD, Crombie C, Taylor EP. Brief report normative data for the HADS from a large non-clinical sample. Br J Clin Psychol. 2001;40:429–34.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.
Karsh I, Jungeblut A, Jenkins L, Kolstad A. Adult literacy in America: a first look at the result of the national adult literacy survey. National Center for Education Statistics, US Department of Education; Washington, DC: 2006.
Pennebaker JW, Beal SK. Confronting a traumatic event: toward an understanding of inhibition and disease. J Abnorm Psychol. 1986;95:274–81.
Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M, et al. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep. 2018;7:40511.
Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol. 2001;110:585–99.
McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45:1027–35.
This study was supported by the Mildred Stahlman Division of Neonatology at Vanderbilt University Medical Center. Statistical support was provided by the Vanderbilt Institute for Clinical and Translational Research.
This study was funded by Vanderbilt Institute for Clinical and Translational Research (VR52927) and the John and Leslie Hooper Neonatal-Perinatal Endowment Fund.
Conflict of interest
The authors declare no competing interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Russell, L.N., Gregory, M.L., Warren, Z.E. et al. Uptake and impact of journaling program on wellbeing of NICU parents. J Perinatol 41, 2057–2062 (2021). https://doi.org/10.1038/s41372-021-00983-1