Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Support Care Cancer. 2022 Oct;30(10):8301-8311. doi: 10.1007/s00520-022-07278-x. Epub 2022 Jul 13.
Although parents with cancer report that talking with their children about cancer and dying is distressing, accessible support is rare. We assessed the feasibility, acceptability, and preliminary effects of Families Addressing Cancer Together (FACT), a web-based, tailored psychosocial intervention to help parents talk about their cancer with their children.
This pilot study used a pre-posttest design. Eligible participants were parents with new or metastatic solid tumors who had minor (ages 3-18) children. Participants who completed baseline assessments received online access to FACT. We assessed feasibility through enrollment and retention rates and reasons for study refusal. Acceptability was evaluated by satisfaction ratings. We examined participants' selection of intervention content and preliminary effects on communication self-efficacy and other psychosocial outcomes (depression and anxiety symptoms, health-related quality of life, family functioning) at 2- and 12-week post-intervention.
Of 68 parents we approached, 53 (78%) agreed to participate. Forty-six parents completed baseline assessments and received the FACT intervention. Of the 46 participants, 35 (76%) completed 2-week assessments, and 25 (54%) completed 12-week assessments. Parents reported that FACT was helpful (90%), relevant (95%), and easy to understand (100%). Parents' psychosocial outcomes did not significantly improve post-intervention, but parents endorsed less worry about talking with their child (46% vs. 37%) and reductions in the number of communication concerns (3.4 to 1.8).
The FACT intervention was feasible, acceptable, and has potential to address communication concerns of parents with cancer. A randomized trial is needed to test its efficacy in improving psychological and parenting outcomes.
This study was IRB-approved and registered with clinicaltrials.gov (NCT04342871).
尽管癌症患儿的父母报告称，与子女谈论癌症和死亡会令他们感到痛苦，但可获得的支持却很少。我们评估了 Families Addressing Cancer Together（FACT）的可行性、可接受性和初步效果，这是一种基于网络的、量身定制的心理社会干预措施，旨在帮助父母与子女谈论癌症。
这项试点研究采用了前后测试设计。合格的参与者是患有新发或转移性实体肿瘤的父母，他们有未成年子女（年龄 3-18 岁）。完成基线评估的参与者可在线访问 FACT。我们通过入组率和保留率以及研究拒绝的原因评估了可行性。可接受性通过满意度评分进行评估。我们在干预后 2 周和 12 周评估了参与者对干预内容的选择以及对沟通自我效能和其他心理社会结果（抑郁和焦虑症状、健康相关生活质量、家庭功能）的初步影响。
在我们接触的 68 位父母中，有 53 位（78%）同意参与。46 位父母完成了基线评估并接受了 FACT 干预。在 46 位参与者中，有 35 位（76%）完成了 2 周评估，有 25 位（54%）完成了 12 周评估。父母报告说 FACT 很有帮助（90%）、相关（95%）且易于理解（100%）。干预后父母的心理社会结果没有显著改善，但父母表示对与孩子交谈的担忧减少（46% vs. 37%），沟通问题的数量减少（3.4 个降至 1.8 个）。
FACT 干预措施是可行的、可接受的，并有潜力解决癌症患儿父母的沟通问题。需要进行随机试验来测试其改善心理和育儿结果的效果。
这项研究得到了机构审查委员会的批准，并在 clinicaltrials.gov 上注册（NCT04342871）。
