Feasibility and Acceptability: Narrative Writing with Caregivers in Pediatric Critical Care

Pediatric intensive care unit (PICU) admissions are caregiver stressors with potential long-term impact. Writing interventions have shown health benefits, although not yet with parents writing during their child's PICU admission. The study objective was to quantify intervention acceptability and feasibility and to qualitatively examine written texts. This is a proof-of-concept three-arm randomized trial. Subjects were legal caregivers ≥18 years, able to read and write English, and of children ≤18 years in a U.S. PICU for ≥1 day. Treatment Acceptability Questionnaire, enrollment rates, completed encounters, and qualitative thematic analysis. Acceptability was high (49% enrollment; mean [standard deviation] Treatment Acceptability Questionnaire scores: M = 24.8 [2.4]). Feasibility was 100% scheduled-to-completed sessions. Thematic analysis revealed two themes (people and relationships); texts were more cognitive than emotional. Caregivers, provided resources and supported by a narrative medicine facilitator, are likely to engage in expressive writing. The intervention warrants subsequent development.