Aim
To explore the relationship between psychological distress and diary sharing in patients and relatives, by investigating: 1) diary usage, 2) diary perception and 3) symptoms of psychological stress.

Design
Convergent mixed methods study.

Setting
Two intensive care units using patient diaries written by relatives with nurse guidance and shared with the patient after discharge.

Data
Self-reported scores of symptoms of posttraumatic stress, anxiety, depression and diary usage were crossed with qualitative description of diary usage and diary perception in 10 patients and 11 relatives.

Results
Most relatives expressed positive perceptions of diary usage; sharing the diary with the patient was related to fewer symptoms of posttraumatic stress. Patients had a positive perception of diary sharing, but symptoms of posttraumatic stress were unchanged.

Conclusion
Reflecting on the tribulations of critical illness and later sharing reflections with the patient were related to lower rates of posttraumatic stress in relatives, suggesting that the act of writing and sharing a diary could have a protective effect. Delayed diary sharing did not have the same effect on patients but might enhance support between relatives and patients.