Nakamura Zev M, Deal Allison M, Yopp Justin M, Wardell Alexis C, Manning Michelle, Pak Phoebe, Cassidy Anna, Hanson Laura C, Jung Ahrang, Song Mi-Kyung, Valle Carmina G, Walker Cole, Won Hannah, Park Eliza M, Rosenstein Donald L
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Psychooncology. 2025 Jan;34(1):e70072. doi: 10.1002/pon.70072.
To evaluate the feasibility, acceptability, and preliminary efficacy of Families Addressing Cancer Together (FACT), a web-based, individually tailored, psychoeducational intervention for parents with cancer to improve illness-related communication with their minor children.
Parents with stage I-IV solid tumors who had children ages 3-17 were randomized to 6 weeks of FACT versus waitlist control. Feasibility was assessed by rates of recruitment and retention. Acceptability (primary outcome) was defined a priori as ≥ 75% of FACT participants rating FACT ≥ 12 (on an 18-point study-specific scale), and semi-structured interviews provided additional qualitative acceptability information. Generalized estimating equation methods were used to assess preliminary efficacy for communication self-efficacy, depression, and anxiety; Fisher's exact tests explored differences in individual communication beliefs and behaviors.
Forty-eight approached patients enrolled (recruitment rate: 73%), 85% were retained through the post-intervention assessment, and 78% rated FACT as acceptable. In the FACT group compared to control, the modeled improvement in CSES scores from baseline to post-intervention was 9.5 versus 0 points (p = 0.004). FACT participants were more likely to have told their children that they have cancer (83.3% vs. 52.2%, p = 0.03) and felt more prepared to answer their children's questions about cancer (p = 0.02). Groups did not differ in depression or anxiety.
FACT was feasible, acceptable, and demonstrated potential to improve parents' communication self-efficacy, beliefs, and behaviors. A large scale randomized controlled trial of FACT is needed to confirm these benefits and evaluate longer-term effects on psychological outcomes for parents with cancer and their children.
评估“共同应对癌症家庭”（FACT）这一基于网络的、针对患癌父母的个性化心理教育干预措施的可行性、可接受性和初步疗效，该干预旨在改善他们与未成年子女之间与疾病相关的沟通。
患有I-IV期实体瘤且子女年龄在3至17岁之间的父母被随机分为两组，一组接受为期6周的FACT干预，另一组为等待名单对照组。通过招募率和留存率评估可行性。可接受性（主要结果）预先定义为≥75%的FACT参与者将FACT评为≥12分（在18分的特定研究量表上），半结构化访谈提供了额外的定性可接受性信息。使用广义估计方程方法评估沟通自我效能感、抑郁和焦虑的初步疗效；Fisher精确检验探讨个体沟通信念和行为的差异。
48名被邀请的患者入组（招募率：73%），85%的患者在干预后评估中被留存，78%的患者将FACT评为可接受。与对照组相比，FACT组从基线到干预后的沟通自我效能感量表（CSES）评分的模拟改善为9.5分，而对照组为0分（p = 0.004）。FACT参与者更有可能告诉他们的孩子自己患了癌症（83.3%对52.2%，p = 0.03），并且感觉更有准备回答孩子关于癌症的问题（p = 0.02）。两组在抑郁或焦虑方面没有差异。
FACT是可行的、可接受的，并显示出改善父母沟通自我效能感、信念和行为的潜力。需要对FACT进行大规模随机对照试验，以证实这些益处并评估对患癌父母及其子女心理结果的长期影响。
