Lundgren Johan, Reuther Christina, Farrand Paul, Lutvica Nina, Thiblin Ella, Essen Louise von, Woodford Joanne
Department of Women's and Children's Health, CIRCLE - Complex Intervention Research in Health and Care, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 05, Sweden.
Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden.
BMC Psychol. 2025 May 27;13(1):565. doi: 10.1186/s40359-025-02860-4.
Childhood cancer treatment completion is a period of vulnerability for parents and is associated with depression, anxiety, restrictions on daily life, and negative socioeconomic consequences. Understanding what helpful and unhelpful coping strategies parents utilize to manage cancer-related distress and concerns may inform the development of tailored psychological support. However, coping strategies used by parents who seek psychological support related to their child's cancer are not well described. To address this gap, we conducted an embedded semi-structured interview study with parents enrolled into the feasibility study ENGAGE. The overall aim of ENGAGE was to examine the acceptability and feasibility of an internet-administered, guided, low intensity cognitive behavioral therapy based self-help intervention, EJDeR. Study aims were to: (1) describe coping strategies used by parents who seek psychological support after end of treatment to cope with cancer-related distress and concerns and (2) consider these coping strategies to inform ongoing adaptations to the EJDeR intervention, taking potential gender differences in coping and subsequent support needs into consideration.
Seventy-three semi-structured interviews were conducted. Data was coded using inductive manifest content analysis and subsequently triangulated with a secondary theory-driven data analysis guided by the control-based model of coping.
Parents used three primary control coping strategies: utilizing tools and techniques, striving for a healthy and balanced lifestyle, and seeking support. Parents used three secondary control coping strategies: accepting and refocusing, adapting to the situation with help from others, and distracting temporarily. Parents used one disengagement-focused coping strategy: avoiding and distancing.
Parents adopted both primary and secondary control coping strategies as well as disengagement-focused coping strategies in accordance with the control-based model of coping. Findings supported the choice of low intensity cognitive behavioral therapy techniques used in the EJDeR intervention to target behavioral and experiential avoidance (i.e., disengagement-focused coping). A need to emphasize the importance of seeking social support in future EJDeR adaptations was identified. Understanding coping strategies used by parents of children off treatment who seek psychological support may inform the development of other psychological interventions for the population.
ISRCTN57233429 ( https://doi.org/10.1186/ISRCTN57233429 ; registration date 19/04/2018).
儿童癌症治疗结束后，对于父母来说是一个脆弱时期，与抑郁、焦虑、日常生活受限以及负面的社会经济后果相关。了解父母采用哪些有益和无益的应对策略来应对与癌症相关的困扰和担忧，可能会为量身定制心理支持的发展提供信息。然而，寻求与孩子癌症相关心理支持的父母所采用的应对策略并未得到充分描述。为了填补这一空白，我们对参与可行性研究“ENGAGE”的父母进行了一项嵌入式半结构化访谈研究。“ENGAGE”的总体目标是检验一种基于互联网管理、有指导的、低强度认知行为疗法的自助干预措施“EJDeR”的可接受性和可行性。研究目标是：（1）描述治疗结束后寻求心理支持的父母用来应对与癌症相关困扰和担忧的应对策略，以及（2）考虑这些应对策略，以便在考虑到应对方式和后续支持需求方面潜在的性别差异的情况下，为“EJDeR”干预措施的持续调整提供参考。
进行了73次半结构化访谈。数据采用归纳性显性内容分析法进行编码，随后与基于应对控制模型的二级理论驱动数据分析进行三角验证。
父母采用了三种主要的控制应对策略：利用工具和技巧、努力追求健康平衡的生活方式以及寻求支持。父母采用了三种次要的控制应对策略：接受并重新聚焦、在他人帮助下适应情况以及暂时分散注意力。父母采用了一种以脱离为重点的应对策略：回避和疏远。
根据基于应对控制模型，父母采用了主要和次要的控制应对策略以及以脱离为重点的应对策略。研究结果支持了“EJDeR”干预措施中针对行为和体验性回避（即以脱离为重点的应对方式）所采用的低强度认知行为疗法技术的选择。研究发现确定了在未来“EJDeR”调整中强调寻求社会支持重要性的必要性。了解治疗结束后寻求心理支持的儿童父母所采用的应对策略，可能会为针对该人群的其他心理干预措施的发展提供信息。
ISRCTN57233429（https://doi.org/10.1186/ISRCTN57233429；注册日期2018年4月19日）。
