Abstract
BackgroundA substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child’s treatment many parents also experience an economic burden.ObjectiveThe aim of this study was to evaluate the long-term efficacy of Internet-based guided self-help for parents of children on cancer treatment.MethodsThis study was a parallel randomized controlled trial comparing a 10-week Internet-based guided self-help program, including weekly support from a therapist via encrypted email, with a wait-list control condition. The intervention was based on cognitive behavior therapy (CBT) and focused on psychoeducation and skills to cope with difficult thoughts and feelings. Primary outcome was self-reported PTSS. Secondary outcomes were self-reported symptoms of depression, anxiety, health care consumption, and sick leave during the past month. Outcomes were assessed pre- and postintervention and at 12-month follow-up. Parents of children on cancer treatment were invited by health care personnel at pediatric oncology centers, and parents meeting the modified symptom criteria on the PCL-C were included in the study. Self-report assessments were provided on the Web.ResultsA total of 58 parents of children on cancer treatment (median months since diagnosis=3) were included in the study (intervention n=31 and control n=27). A total of 18 participants completed the intervention, and 16 participants in each group participated in the 12-month follow-up. Intention-to-treat analyses revealed significant effects in favor of the intervention on the primary outcome PTSS, with large between-group effect sizes at postassessment (d=0.89; 95% CI 0.35-1.43) and at 12-month follow-up (d=0.78; 95% CI 0.25-1.32). Significant effects in favor of the intervention on the secondary outcomes depression and anxiety were also observed. However, there was no evidence for intervention efficacy on health care consumption or sick leave.ConclusionsUsing the Internet to provide psychological interventions shows promise as an effective mode of delivery for parents reporting an increased level of PTSS and who consider Internet-based interventions as a viable option. Future research should corroborate these findings and also develop and evaluate interventions and policies that may help ameliorate the economic burden that parents may face during their child’s treatment for cancer.
Highlights
Being a parent of a child diagnosed with cancer is burdensome
We have developed a 10-week guided self-help intervention for parents of children on cancer treatment to be administrated via the Internet [17]
We have previously reported that the intervention seems effective in the short term with significant reductions in the primary outcome post-traumatic stress (PTSS) and the secondary outcomes depression and anxiety, with large effect sizes at postassessment compared with a wait-list control condition [18]
Summary
Being a parent of a child diagnosed with cancer is burdensome. During the child’s treatment, parents have to cope with the disease itself, invasive treatments, and uncertainty about the child’s health and outcome. Parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress disorder (PTSS) [1,2,3] and depression [4]. A recent longitudinal study found that the reduction in parents’ working hours is highest 2 months after the child’s diagnosis and almost restored 1 year after end of treatment. A substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child’s treatment many parents experience an economic burden
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