Empowering Parents Through Targeted Journaling to Promote Engagement and Reduce Stress

BACKGROUND: Parents of preterm infants admitted to the neonatal intensive care unit (NICU) experience significant and lasting psychological stress, which can negatively impact both their own well-being and their child's development. To address the need for accessible, low-cost interventions that promote engagement and emotional support, we developed a structured parental journal aimed at enhancing bonding, tracking medical progress, and reducing stress during the NICU stay. PURPOSE: We hypothesized that implementing a structured journal will enhance parental mental well-being and engagement. METHODS: In this pilot RCT, parents of very preterm infants (28 0/7 -33 6/7 weeks' gestation) were randomized to receive the journal or routine NICU care. Outcomes included parental engagement (measured by PREEMI [Parent Risk Evaluation and Engagement Model and Instrument]) and stress (measured by PSS:NICU [Parental Stress Scale: Neonatal Intensive Care Unit]), as well as length of stay, mother's own milk (MOM) use, satisfaction, visitation frequency, and journal use. RESULTS: While parental engagement or parental stress scores did not differ in the 21 families enrolled, the intervention group had significantly shorter NICU stays (25 days vs 55 days) and increased comfort taking their child home (100% vs 64% strongly agree), and trends toward increased MOM usage and visitation frequency. Parents in the journal group reported an improved NICU experience and strongly endorsed journal use. IMPLICATIONS FOR PRACTICE AND RESEARCH: These findings suggest that the use of the journal positively impacts multiple aspects of the parental NICU experience, highlighting its potential to enhance parental engagement and reduce stress in larger, more comprehensive studies.