Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio.
Pediatr Blood Cancer. 2021 Apr;68(4):e28822. doi: 10.1002/pbc.28822. Epub 2020 Dec 23.
Bright IDEAS problem-solving skills training (BI) is an evidence-based behavioral intervention that has been utilized extensively with caregivers of children recently diagnosed with cancer. Considerable evidence has shown that BI is acceptable to caregivers of children recently diagnosed with cancer, and improvements in problem-solving skills mediate reduced symptoms of distress.
A slightly modified version of BI was offered to caregivers of children with sickle cell disease (SCD) in a two-site pilot feasibility trial. BI was modified to reduce barriers to care, logistical challenges, and stigma associated with receiving behavioral health services. Our goal was to establish high rates of recruitment and retention among caregivers of children with SCD. Recruitment was acceptable (94%; N = 72) and retention reasonable (49%) across both sites with 35 caregivers successfully completing the BI program.
Results showed that caregivers of children with SCD, who successfully completed the BI program reported, significant improvements in problem-solving skills immediately and three months after intervention completion. Interestingly, initial levels of distress were low with few caregivers reporting clinically significant levels of distress; distress remained low over time.
Findings are discussed in the context of psychosocial screening and resilience of caregivers of children with SCD.
Bright IDEAS 问题解决技能培训(BI)是一种基于证据的行为干预措施,最近已广泛应用于儿童癌症诊断后的照护者。大量证据表明,BI 被最近被诊断为癌症的儿童的照护者所接受,并且问题解决技能的提高可以减轻痛苦症状。
在一项两站点试点可行性试验中,为镰状细胞病(SCD)患儿的照护者提供了经过略微修改的 BI 版本。BI 经过修改,以减少与接受行为健康服务相关的障碍、后勤挑战和耻辱感。我们的目标是在 SCD 患儿的照护者中建立高招募率和保留率。两个站点的招募率都很高(94%;N=72),保留率也合理(49%),有 35 名照护者成功完成了 BI 计划。
结果表明,成功完成 BI 计划的 SCD 患儿照护者在干预完成后立即和三个月后报告问题解决技能显著提高。有趣的是,初始痛苦水平较低,很少有照护者报告有临床显著水平的痛苦;痛苦随着时间的推移保持较低水平。
在 SCD 患儿照护者的心理社会筛查和适应能力的背景下讨论了这些发现。