Psychological Aspects of Cancer, Danish Cancer Society Research Center, Denmark.
Department of Psychology, University of Copenhagen, Denmark.
J Pediatr Psychol. 2023 Jan 12;48(1):29-38. doi: 10.1093/jpepsy/jsac062.
To examine as secondary analyses the effect the FAMily-Oriented Support (FAMOS) family therapy program on reducing parent-reported medical traumatic stress in the sub-sample of pediatric cancer survivors, age 2-5 years.
The FAMOS study was a national multicenter randomized controlled trial with all four pediatric oncology departments in Denmark (Clinicaltrials.gov [NCT02200731]). Families were randomized in parallel design (1:1) to intervention or usual care. The FAMOS program includes seven home-based psychotherapeutic sessions and is based on family systems therapy to address the individuals in the family system using cognitive behavioral, problem-solving and goal-setting techniques. Questionnaires were completed by parents at baseline, 6, and 12 months. In linear mixed-effects models, the effect of FAMOS on reducing children's trauma-related behavior after 6 and 12 months was examined in 62 children (31 in the intervention and 29 in the control group, respectively). It was also examined if a trauma-related behavior effect was mediated through reduced symptoms of depression in mothers and fathers, respectively.
On average, children in the intervention group experienced significantly larger decreases in trauma-related behaviors at 6 and 12 months than the control group (predicted mean difference -3.89, p = .02 and -6.24, p = .003, respectively). The effect on trauma-related behavior was partly mediated through reduced symptoms of depression in mothers, but not fathers.
Adding to previously reported positive effects of the FAMOS intervention on parents' symptoms of post-traumatic stress and depression, significant improvements were found in young children's trauma related-behavior. Further research is needed to develop therapy for children with cancer.
作为二次分析，研究 FAMily-Oriented Support（FAMOS）家庭治疗方案对减少儿科癌症幸存者（年龄 2-5 岁）中父母报告的医疗创伤后应激的影响。
FAMOS 研究是一项全国多中心随机对照试验，丹麦的所有四家儿科肿瘤学系均参与其中（Clinicaltrials.gov [NCT02200731]）。采用平行设计（1:1）将家庭随机分为干预组或常规护理组。FAMOS 计划包括七次基于家庭的心理治疗课程，基于家庭系统治疗，使用认知行为、解决问题和设定目标的技术来解决家庭系统中的个体。父母在基线、6 个月和 12 个月时完成问卷调查。在线性混合效应模型中，分别在 62 名儿童（干预组 31 名，对照组 29 名）中检查 FAMOS 在 6 个月和 12 个月时减少儿童创伤相关行为的效果。还分别检查了母亲和父亲抑郁症状减轻是否介导了创伤相关行为的影响。
平均而言，干预组儿童在 6 个月和 12 个月时创伤相关行为的下降幅度明显大于对照组（预测平均差异分别为-3.89，p=0.02 和-6.24，p=0.003）。这种对创伤相关行为的影响部分通过母亲抑郁症状的减轻来介导，但不是父亲。
除了 FAMOS 干预对父母创伤后应激和抑郁症状的先前报道的积极影响外，还发现年幼儿童的创伤相关行为有显著改善。需要进一步研究为癌症儿童开发治疗方法。
