Section of Liaison Psychiatry and Palliative Medicine,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Tokyo,Japan.
College of Nursing, University of South Carolina,Columbia,South Carolina.
Palliat Support Care. 2017 Oct;15(5):575-586. doi: 10.1017/S1478951516001115. Epub 2017 Jan 23.
Although support programs for children whose parents have cancer have been described and evaluated, formal research has not been conducted to document outcomes. We adapted a group intervention called CLIMB®, originally developed in the United States, and implemented it in Tokyo, Japan, for school-aged children and their parents with cancer. The purpose of this exploratory pilot study was to examine the feasibility, acceptability, and impact of the Japanese version of the CLIMB® Program on children's stress and parents' quality of life and psychosocial distress.
We enrolled children and parents in six waves of replicate sets for the six-week group intervention. A total of 24 parents (23 mothers and 1 father) diagnosed with cancer and 38 school-aged children (27 girls and 11 boys) participated in our study. Intervention fidelity, including parent and child satisfaction with the program, was examined. The impact of the program was analyzed using a quasiexperimental within-subject design comparing pre- and posttest assessments of children and parents in separate analyses.
Both children and parents experienced high levels of satisfaction with the program. Children's posttraumatic stress symptoms related to a parent's illness decreased after the intervention as measured by the Posttraumatic Stress Disorder-Reaction Index. No difference was found in children's psychosocial stress. The Functional Assessment of Chronic Illness Therapy scores indicated that parents' quality of life improved after the intervention in all domains except for physical well-being. However, no differences were found in parents' psychological distress and posttraumatic stress symptoms.
Our results suggest that the group intervention using the CLIMB® Program relieved children's posttraumatic stress symptoms and improved parents' quality of life. The intervention proved the feasibility of delivering the program using manuals and training. Further research is needed to provide more substantiation for the benefits of the program.
尽管已经描述和评估了针对父母患有癌症的儿童的支持计划，但尚未进行正式研究来记录结果。我们改编了一项名为 CLIMB®的团体干预措施，该措施最初在美国开发，并在日本东京为患有癌症的学龄儿童及其父母实施。本探索性试点研究的目的是检验日本版 CLIMB®计划对儿童压力、父母生活质量和心理社会困扰的可行性、可接受性和影响。
我们分六批招募了参加为期六周的团体干预的儿童及其父母。共有 24 名父母（23 名母亲和 1 名父亲）被诊断患有癌症，38 名学龄儿童（27 名女孩和 11 名男孩）参加了我们的研究。检查了干预的保真度，包括父母和孩子对该计划的满意度。使用准实验内在个体设计，在单独的分析中比较了儿童和父母在预测试和后测试中的评估，分析了该计划的影响。
儿童和父母对该计划都非常满意。通过创伤后应激障碍反应指数（Posttraumatic Stress Disorder-Reaction Index）测量，儿童与父母疾病相关的创伤后应激症状在干预后有所下降。儿童的心理社会压力没有差异。慢性疾病治疗功能评估（Functional Assessment of Chronic Illness Therapy）分数表明，除身体福祉外，父母的生活质量在干预后所有领域都有所提高。然而，父母的心理困扰和创伤后应激症状没有差异。
我们的结果表明，使用 CLIMB®计划的团体干预减轻了儿童的创伤后应激症状并改善了父母的生活质量。该干预证明了使用手册和培训提供该计划的可行性。需要进一步的研究为该计划的益处提供更多依据。
