Wan Ghazali Wan Syahirah, Minhat Halimatus Sakdiah, Mohd Sidik Sherina, Mohd Nazan Iqmer Nashriq
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
Department of Psychiatry, Faculty of Medicine, and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
PLoS One. 2025 Feb 5;20(2):e0318104. doi: 10.1371/journal.pone.0318104. eCollection 2025.
Mothers caring for children with cancer often experience depression, affecting maternal and family well-being. Prior studies suggest that theory-based health education can significantly reduce this depression.
This study aimed to develop, validate, implement, and evaluate the effects of a Social Cognitive Theory (SCT)-based health education intervention on depression (SCODESS), as well as cancer-related knowledge, self-efficacy, perceived stress, coping skills, and social support among mothers of children with cancer at University Hospitals in Klang Valley.
A quasi-experimental study was conducted with mothers from two University Hospitals in Klang Valley, Selangor. The intervention group is Hospital Pakar Kanak-Kanak Universiti Kebangsaan Malaysia (HPKK UKM) and the control group is the Universiti Malaya Medical Centre (UMMC). A total of 95 participants were included (50 intervention, 45 control). The intervention comprised online health education videos delivered over one week, and the control group received a poster. Data were collected at baseline (T1), immediately post-intervention (T2), and at two months post-intervention (T3). The effects of SCODESS intervention were analysed using Generalised Estimating Equation (GEE) analysis.
The baseline response rate was 60.53% with a 2.17% loss to follow-up at T2 and 7.60% at T3. The GEE analysis showed no significant effects of SCODESS intervention on depression scores at T2 (p = 0.909) and T3 (p = 0.622) compared to the control group at baseline. However, statistically significant increases were observed in cancer-related knowledge scores at T2 (β = 0.66, 95%CI: 0.21, 9.20, p = 0.002) and T3 (β = 1.18, 95%CI: 0.65, 1.70, p<0.001), and in the problem-focused coping scores at T2 (β = 2.50, 95% CI 0.42, 4.58, p-value = 0.018), and T3 (β = 2.42, 95% CI 0.13, 4.72, p-value = 0.038) in the intervention group compared to the control group at baseline. No significant intervention effects were observed on other outcomes.
This study validated the applicability of SCT-based intervention on depression scores among mothers of children with cancer. The SCODESS intervention did not significantly reduce depression scores but significantly increased cancer-related knowledge and problem-focused coping scores. As a potential preventive strategy for depression, the content of the SCODESS intervention should be revisited, emphasizing cancer-related knowledge and problem-focused coping as crucial components. It is recommended that tailored interventions focusing on these areas be offered to every mother of children with cancer, whether they are in the ward, clinic, or daycare.
照顾患癌儿童的母亲常常会经历抑郁，这会影响母亲和家庭的幸福。先前的研究表明，基于理论的健康教育能够显著减轻这种抑郁。
本研究旨在开发、验证、实施并评估基于社会认知理论（SCT）的健康教育干预措施对抑郁的影响（SCODESS），以及对巴生谷大学医院中患癌儿童母亲的癌症相关知识、自我效能感、感知压力、应对技能和社会支持的影响。
对来自雪兰莪州巴生谷两所大学医院的母亲进行了一项准实验研究。干预组是马来西亚国立大学儿童专科医院（HPKK UKM），对照组是马来亚大学医学中心（UMMC）。总共纳入了95名参与者（50名干预组，45名对照组）。干预措施包括在一周内提供在线健康教育视频，对照组则收到一张海报。在基线（T1）、干预后即刻（T2）和干预后两个月（T3）收集数据。使用广义估计方程（GEE）分析来分析SCODESS干预的效果。
基线反应率为60.53%，T2时随访失访率为2.17%，T3时为7.60%。GEE分析显示，与基线时的对照组相比，SCODESS干预在T2（p = 0.909）和T3（p = 0.622）时对抑郁评分没有显著影响。然而，干预组在T2（β = 0.66，95%CI：0.21，9.20，p = 0.002）和T3（β = 1.18，95%CI：0.65，1.70，p<0.001）时的癌症相关知识得分，以及在T2（β = 2.50，95%CI 0.42，4.58，p值 = 0.018）和T3（β = 2.42，95%CI 0.13，4.72，p值 = 0.038）时的问题聚焦应对得分与基线时的对照组相比有统计学意义的增加。在其他结果上未观察到显著的干预效果。
本研究验证了基于SCT的干预措施对患癌儿童母亲抑郁评分的适用性。SCODESS干预没有显著降低抑郁评分，但显著提高了癌症相关知识和问题聚焦应对得分。作为一种潜在的抑郁预防策略，应重新审视SCODESS干预的内容，强调癌症相关知识和问题聚焦应对是关键组成部分。建议为每位患癌儿童的母亲提供针对这些领域的量身定制的干预措施，无论她们是在病房、诊所还是日托中心。
