Introduction For many families and some staff Religion and Spirituality (R/S) is an important aspect of a child’s critical illness. Holistic care requires adaptation too, and support of, the role of R/S on PICU. Faith-based beliefs offer additional facets to critical care, particularly difficult treatment decisions – but the role of R/S support e.g. chaplaincy is little explored. This study was conducted to determine the role of R/S for parents and staff in a UK tertiary-PICU with integrated multi-faith chaplaincy, including differences in views.

Methods Qualitative interview-based study: (i) families recently discharged from PICU; (ii) PICU staff. In-depth semi-structured interviews to encourage participant narrative with prompts: Religious affiliation, changes/affirmations in faith during PICU stay; experience of hospital chaplaincy and other healthcare staff; memorable occasions where R/S played integral role (positive or negative); staff attitudes towards religion and ability to discuss topic. Interviews recorded, transcribed and thematically analysed using Braun and Clark’s framework: Data immersion, followed by coding and subsequent allocation to appropriate themes.

Results 6 parents and 8 staff participated until saturation. Six distinct themes emerged: Themes exclusive to staff included major R/S role in parental decision making, rationalisation of ICU with faith allowing parents to try to maintain control. Parents identified religion as: a source of comfort, hope and perspective though demonstrated relative polarisation in previous faith i.e. becoming extremely religious or rejecting previous faith. The supportive role of chaplaincy was recognised by both parents and staff, but there was a discrepancy between attitudes towards miracles.

Conclusions PICU families would welcome staff training on religious and spiritual issues, whereas staff, whilst welcoming R/S support for families, are concerned about its role in critical care decision, not least in the context of miraculous interventions. The role of chaplaincy was welcomed by all, especially its integration on PICU, with no concerns about visibility.