Nemours Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE, USA.
Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA.
J Pediatr Psychol. 2023 Mar 20;48(3):216-227. doi: 10.1093/jpepsy/jsac082.
Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cancer Competently Intervention Program (eSCCIP) is a psychosocial eHealth intervention for caregivers, developed using an iterative, user-centered process.
eSCCIP was tested in a single-arm pilot trial at Nemours Children's Hospital, Delaware (NCT05333601). The primary outcomes were intervention acceptability and feasibility, assessed via enrollment and retention targets, and item-level acceptability ratings. Enrollment and retention targets of 45% were set based on previous work, and an item-level acceptability threshold of 80% was set. A secondary exploratory analysis was conducted examining acute distress, anxiety, symptoms of post-traumatic stress, and family functioning.
44 caregivers enrolled in the study and 31 completed. The intervention was rated favorably by completers, with over 80% of the sample selecting "mostly true" or "very true" for all items of the eSCCIP Evaluation Questionnaire, which was used to assess acceptability and feasibility. Enrollment and retention rates were 54% and 70%, respectively. Exploratory psychosocial outcomes showed statistically significant decreases from pre-intervention to post-intervention for overall symptoms of post-traumatic stress disorder (PTSD), cluster D symptoms of PTSD (negative mood and cognitions), and anxiety. Small-moderate effect sizes were observed for all psychosocial outcomes of interest.
eSCCIP is an acceptable and feasible intervention for caregivers. Results are promising regarding reductions in symptoms of post-traumatic stress and anxiety.
为父母和其他儿童癌症(以下简称照顾者)的主要照顾者提供高质量的社会心理关怀很重要,因为儿科癌症诊断与照顾者负面心理社会后果增加相关的诸多挑战。电子肿瘤患者生存能力熟练干预计划(eSCCIP)是一种针对照顾者的社会心理电子健康干预措施,是使用迭代、以用户为中心的过程开发的。
eSCCIP 在特拉华州 Nemours 儿童医院进行了一项单臂试验(NCT05333601)。主要结果是通过入组和保留目标以及项目层面的可接受性评分来评估干预的可接受性和可行性。基于先前的工作设定了 45%的入组和保留目标,设定了 80%的项目层面可接受性阈值。进行了二次探索性分析,检查急性痛苦、焦虑、创伤后应激症状和家庭功能。
44 名照顾者参加了这项研究,其中 31 人完成了研究。完成者对干预措施评价良好,超过 80%的样本对 eSCCIP 评估问卷的所有项目选择“大部分正确”或“非常正确”,该问卷用于评估可接受性和可行性。入组率和保留率分别为 54%和 70%。探索性心理社会结果显示,总体创伤后应激障碍(PTSD)症状、PTSD 簇 D 症状(负性情绪和认知)和焦虑从干预前到干预后均有统计学显著下降。所有感兴趣的心理社会结果均观察到小到中等效应量。
eSCCIP 是一种照顾者可接受且可行的干预措施。在减轻创伤后应激和焦虑症状方面,结果是有希望的。