Distress In Parents Of Children Research Articles

Emotional State among Parents of Children with Type 1 Diabetes and its Association with Disease Control

Abstract Background Type 1 diabetes is one of the commonest chronic childhood diseases. It can be diagnosed at any age; peaks in onset occur between 5 and 7 years of age and near puberty. The aim of this work was to assess psychological distress in parents of children with T1DM in comparison to parents of non-diabetic children and to assess the impact of parent's stress on control of diabetes on their children. Methods This comparative cross-sectional study was carried out on 105 parents of children diagnosed with type 1 diabetes recruited from diabetes clinic and 105 parents of non-diabetic children recruited from general paediatric clinic, age of parents was from 25 to 45 years and of child was from 2 to 5 years, both sexes. Participants were divided in to two equal groups: group A: parents of children diagnosed with type 1 diabetes (case group). Group B: parents of non-diabetic children (control group). Results There was statistically significant increase in the percentage of parents with moderate stress in cases group [83 (79%)] than in control group [68 (65.4%)] and also increase in the percentage of severe cases in control group [29 (27.9%)] than cases group [10 (9.5%)] with p-value = 0.002. Also, no statistically significant difference found between both groups regarding assessment of anxiety by Hamilton anxiety rating scale with p-value = 0.420. While there was statistically significant increase in the percentage of parents with severe depression assessed by Beck depression Inventory II among parents of cases group [27 (25.7%)] than parents of control group 1 (1%) with p-value <0.001. While there was statistically significant increase in the percentage of parents with no depression assessed by Beck depression Inventory II among parents of cases group [40 (38.1%)] than parents of control group 0 (0%) with p-value <0.001. There was statistically significant positive correlation between perceived stress scale and Hamilton anxiety rating scale and also Beck depression inventory scale. Also, there was statistically significant positive correlation found between Hamilton anxiety rating scale and beck depression inventory scale. Conclusions Parents of diabetic children are at increased risk for stress, depression and anxiety which in turn negatively affect control of diabetes in children.

The mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer.

Caring for children with cancer is stressful for parents and leads to psychological distress, which is mainly manifested as depressive symptoms and anxiety. This study explored the mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer. We recruited 258 parents of children with cancer in three tertiary hospitals in Mainland China. The results revealed that the mediating effect of resilience for the relationships between stress and depressive symptoms and between stress and anxiety accounted for 23.4% and 11.4%, respectively, of the total effect. Resilience was confirmed as a protective factor that can be incorporated into future intervention programmes to improve the psychological well-being of parents of children with cancer. Future studies could develop resilience training programmes to enhance the resilience of parents of children with cancer to alleviate parents' psychological distress.

Accidental lipid overdose in a preterm infant: A case report.

Intravenous lipid emulsions (ILEs) provide essential fatty acids during parenteral nutrition (PN). Serious adverse events including death can occur from overdose. We report an accidental overdose in a preterm infant. On Day 2 of life, a 29-week gestational age (GA) twin was accidentally given 47.5 mL of Intralipid20% (≈3x daily amount) in 50-minutes. No apparent clinical deterioration occurred, although blood samples were lipaemic. Outcomes at 2 years corrected GA were similar to that of his twin. Service changes were made to infusion packaging and administration to avoid similar errors. Medication errors in neonates are unfortunately common. Published articles usually focus on poor outcomes, which can increase the distress for parents of children where errors have occurred. Publishing the full spectrum of outcomes instead allows parents and professionals to be aware of all possibilities and lessons learnt, even if serious harm was avoided.

Dimensionality and psychometric properties of the Parent Diabetes Distress Scale-Greek (PDDS-Gr).

Type 1 diabetes (T1D) is a chronic disease characterised by insulin deficiency due to autoimmune destruction of beta-pancreatic cells. T1D, formerly known as juvenile diabetes, is the most common form of diabetes in children and adolescents. On diagnosis, parents of children with TID experience considerable stress, because they need to care for a child in a challenging and life-threatening situation that requires adherence to an intensive medical regimen, constant monitoring of, and coping with their child's condition. T1D is a complex condition that affects both children and their parents in many aspects of their daily lives. This study presents the psychometric properties of the Greek translation of the Parent Diabetes Distress Scale (PDDS), which assesses diabetes distress in parents of children with T1D. A sample of 95 parents, mainly mothers (88.4%), with a mean age of their children 12.2 years (± 3.6) and a diabetes duration of 4.7 years (± 3.4), completed the Greek translation of the PDDS. Exploratory factor analysis (EFA) revealed a five-factor model: 'Parent/child relationship distress', 'Personal distress', 'Child diabetes management distress', 'Future distress', and 'Healthcare team distress'. Confirmation Factor Analysis (CFA) confirmed the construct validity of the scale. The internal consistency indices (Cronbach alpha) for the subscales ranged from 0.69 to 0.89, while the unidimensional structure had an alpha of 0.90. Furthermore, convergent validity was shown with moderate positive correlations between the PDDS-Gr and the subscales of the DASS-21 (depression, anxiety, and stress), the child's age (in years), and the HbA1c value. Finally, parents of children with inadequate glycemic control (HbA1c ≥ 7%) presented higher scores on both the unidimensional structure and the subscales 'Parent/child relationship distress' and 'Healthcare team distress' of the PDDS-Gr. The PDDS-Gr is a valid and reliable tool for assessing diabetes distress in parents of children with T1D and can be used in both clinical and research settings.

Association of physical activity with psychological distress and happiness in mothers of children with autism spectrum disorders during the COVID-19 pandemic

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic may have severely impacted the psychological status of mothers of children with autism spectrum disorder (ASD). Although a previous study reported that physical activity (PA) moderated psychological distress in parents of children with ASD during the COVID-19 pandemic, the effect of PA on the happiness levels of such parents during the pandemic remains unclear. This study investigated the associations among PA, psychological distress, and happiness in mothers of children with ASD during the COVID-19 pandemic.MethodsThis cross-sectional study was designed to evaluate mothers of children with disabilities. Questionnaires were collected from mothers living in Yamaguchi and Okayama Prefectures, Japan, between February and December 2022. During this period, three large waves of the COVID-19 pandemic occurred in Japan. Of the 601 respondents, 334 mothers had children with ASD and offered valid data. PA was assessed using the short form of the International Physical Activity Questionnaire. Psychological distress and happiness were assessed using the six-item Kessler Psychological Distress Scale (K6) and the Subjective Happiness Scale (SHS).ResultsThe mothers had markedly higher K6 scores (6.49) and more than half of them had moderate-to-severe psychological distress, whereas the SHS scores (4.46) were similar to that of the general Japanese population. In a multivariable-adjusted model based on the analysis of covariance, the K6 score was not associated with any PA items. In contrast, SHS scores were positively associated with moderate-intensity PA (MPA) and total moderate- to vigorous-intensity PA (MVPA), independent of K6. In the post-hoc test, mothers who did some (4.52) or enough (≥ 150 min/week) MPA (4.56) had a higher SHS score than those who did not (4.09). Similarly, mothers who engaged in sufficient (≥ 600 MET-min/week) total MVPA had higher SHS scores (4.57) than those who did not engage in MVPA (4.12).ConclusionsThe mothers of children with ASD during the COVID-19 pandemic had markedly higher psychological distress, though none of the PA items were associated with stress levels. However, PA was positively associated with happiness in mothers of children with ASD independent of their stress levels.

Stress and Coping Factors Affecting Health-Related Quality of Life in Parents of Children with Congenital Heart Disease: An Integrative Review.

Parents of children with congenital heart disease experience unique stressors that affect their psychological well-being and health-related quality of life. A parent's ability to cope effectively influences how they adjust to stressful situations. The purpose of this review is to synthesize the factors influencing HRQoL in parents of children with congenital heart disease under the lens of the Transactional Model of Stress and Coping framework to identify areas for intervention and future research. An integrative literature review was conducted by keyword search of online databases PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Medline from 2011 to 2022. Inclusion and exclusion criteria were applied to search results and studies were assessed for quality using the Mixed Method Appraisal Tool. The initial search yielded 1026 unique papers, and 24 were included based on the predefined criteria. The Transactional Model of Stress and Coping was applied to organize results and generate themes. Results showed a child's hospitalization is a time of uncertainty and distress for parents of children with congenital heart disease. Effective problem-focused and emotion-focused coping strategies can lead to reduced stress and improved health-related quality of life for parents. Additionally, multiple variables moderate the relationship between a parent's perceived stress and adjustment. Health care teams should focus on targeted education, faith, coping, and social support interventions. Further research is needed that examines the effect of mental health factors, cultural differences, and socioeconomic variables on the health-related quality of life of parents of children with congenital heart disease.

Parenting stress, general distress, and coparenting quality: An Actor–Partner Interdependence Moderation Model

AbstractMothers and fathers who experience parenting stress are more likely to show symptoms of distress, such as elevated levels of anxiety and/or depression. Identifying the buffering or exacerbating factors that might moderate the association between parenting stress and general distress can help inform theoretical models aimed at better understanding the reality faced by parents during challenging times, as well as improve intervention strategies. The objective of this study was to examine whether coparenting quality plays a moderating role in the association between parenting stress and general distress in parents of children in middle childhood. Eighty‐one couples were asked to complete questionnaires pertaining to their levels of parenting stress, the quality of their coparenting relationship, and their symptoms of distress. Using an Actor–Partner Interdependence Moderation Model, our results revealed that elevated levels of parenting stress were associated with elevated levels of general distress, whereas higher scores of coparenting quality were associated with fewer symptoms of distress. Our results also showed a moderating role for coparenting quality in the association between actor parenting stress and actor/partner distress. These findings highlight the importance of pursuing the investigation of dyadic effects within personal relationships.

Parenting Self-Efficacy and Psychological Distress in Parents of Children with an Autism Spectrum Disorder.

Research suggests that challenges associated with raising a child with an Autism Spectrum Disorder (ASD) can increase parents' risk for diminished parenting self-efficacy (PSE) and psychological wellbeing. The present study aimed to explore interrelationships between noteworthy predictors of PSE and parental psychological distress, including parental mastery beliefs and the co-parenting relationship amongst 122 Australian parents of children with autism. Results indicated that greater mastery beliefs and more favourable co-parenting relationships predicted greater PSE, and higher PSE predicted less psychological distress. PSE significantly mediated relationships between mastery beliefs and psychological distress, and between the co-parenting relationship and psychological distress. Findings have implications that can aid professionals to more effectively support parents raising children on the autism spectrum.

PENERAPAN MODEL KONSELING SPIRITUAL TEISTIK UNTUK MENINGKATKAN SPIRITUAL WELL BEING ORANG TUA ABK DI SLB NEGERI HARURU

Being a parent with a child with special needs puts pressure on them because they have to pay more attention, not the same as normal children in general and often this pressure has the impact of psychological distress on parents. This also happened to parents of children with special needs at the Haruru State SLB. Psychological distress for parents of children with special needs greatly impacts various aspects, one of which is spiritual well being. Based on research conducted by several parents of children with special needs, they have low spiritual well being, therefore it is necessary to have therapy to improve their spiritual well being. The counseling method used to improve low spiritual well being is spiritual counseling with ten counseling sessions. There were 6 participants involved and all of these participants attended counseling until the last session. The results of the study show that theistic spiritual counseling is effective in improving the spiritual well being of parents of children with special needs who experience psychological distress. This can be seen from the sig value of 0.061 that there were changes before and after counseling was carried out for parents of children with special needs.

Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome.

Parents of children with diagnoses of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) may experience significant psychological distress related to their child's severe and relapsing illness and challenges with the traumatic nature of its treatment. No manualized or studied psychological interventions specifically for parents of youth with PANS have existed prior to this study. In this pilot study, we assessed the feasibility, satisfaction, and treatment fidelity of a brief 9-session group therapy intervention for parents based on principles of trauma-focused cognitive behavior therapy (CBT). We hypothesized that, if initially elevated, symptoms of depression, anxiety, and trauma would decrease and participants' utilization of positive coping mechanisms would increase post-intervention. We adapted an existing evidence-based group intervention developed for parents of children with premature infants to target sources of stress and coping in parents of children with PANS. Ten parents participated in the study. The 9-session intervention used a combination of techniques that included cognitive restructuring, coping skills, self-care, and a trauma narrative to address psychological stress, trust, grief, and unwanted emotions. Outcome measures included parental symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), as well as rating of parental satisfaction with the intervention. The treatment was feasible and deliverable with high fidelity. The intervention was rated as useful and satisfactory by parents (overall average usefulness of 4.54 and satisfaction of 4.71 out of 5.0). Elevated symptoms of PTSD and depression decreased with large effect sizes (Cohen's d = 1.42 and Cohen's d = 1.38, respectively). Participating parents demonstrated significantly more active coping and acceptance behaviors and stances. A brief 9-session group therapy intervention based on principles of trauma-focused CBT was found to be effective in reducing symptoms of psychological distress in parents of children with PANS.

Identifying parent anxiety and family distress of critically ill children in response to changes in hospital visitation policies during the COVID-19 pandemic

PurposeThis research study describes parent anxiety and family distress among three study groups of varying restrictions in parent presence for children in the PICU during a pandemic. Design and methodsA retrospective study was conducted to describe differences in parent anxiety and family distress for parents of children hospitalized before and during the COVID-19 pandemic. Participants fell into three study groups based on the dates of the child's hospital stay and the level of parent and family presence or restriction they experienced. Participants were asked to complete a survey that included basic demographic information along with utilization of the GAD-7 and FDI measures. The data were assessed using descriptive statistics, Fisher's exact test, and the Kruskal-Wallis test. ResultsA total of 82 parents of children hospitalized during the specified times in the PICU participated. There was a statistically significant difference among the three cohorts in diagnoses (respiratory, cardiovascular, and medical-surgical), p ≤0.001. A larger percentage of children of the study participants were hospitalized with respiratory illnesses (62.5%) in the unrestricted study group when compared to the other study groups with higher patient acuity. There was also a statistical significance among the three study groups regarding whether the second parent was able to visit the child during the PICU admission (p = 0.007). ConclusionsOur study suggests that restricting parent and visitor presence does not increase parent anxiety or family distress during a child's admission to the PICU. The literature widely supports that having a critically ill child is undoubtedly stressful for parents and families, but the most significant causation for the anxiety and stress remains unknown and is likely multifactorial. Clinical and research implicationsParents who experienced rigid restrictions in parent and visitor presence did not have increased anxiety. Other impactful variables such as a child's mortality risk and the uncertainty of outcome may have impacted anxiety for parents whose children were critically ill. Further research is needed to understand which stressors are most significant, during a critically ill child's hospitalization, from a parent's perspective. Limiting staff and patient exposure to persons who may have contagious illness (restricting parent and family presence) may not in itself lead to increased anxiety and distress for parents and families. This study may provide context for careful development of hospital visitation policies to ensure balance between patient and family centered care and protection from infectious disease.

ВОЗМОЖНОСТИ ПРИМЕНЕНИЯ ТЕЛЕМЕДИЦИНСКИХ ТЕХНОЛОГИЙ ПРИ НАБЛЮДЕНИИ ДЕТЕЙ С ВПЕРВЫЕ ВЫЯВЛЕННЫМ САХАРНЫМ ДИАБЕТОМ 1-го ТИПА

Effective control of type 1 diabetes mellitus (DM1) is a difficult and burdensome task for the patient and/or his/her parents/caretakers as well as healthcare professionals. Another approach to improve glycemic control could be the use of telemedicine. The purpose of this study was to evaluate the possibility and effectiveness of remote monitoring and education of children with newly diagnosed DM1. Materials and methods of the research: a multicenter prospective open uncontrolled experimental clinical study was conducted between Oct. 2020 and Feb. 2022. The study was conducted in the two clinical centers as follows: Endocrinology Research Centre of the Ministry of Healthcare of Russia; and M.F. Vladimirsky Moscow Oblast Regional Scientific and Research Clinical Institute (MONIKI), both located in Moscow, Russia. Children aged 1 to 18 years old diagnosed with DM1 within 12 weeks prior to inclusion in the study and receiving intensified insulin therapy were invited to participate in the study. Results: the study included 220 children with DM1 living overall the Moscow Oblast region aged 1 to 18 years old (median age 8.1 (5.1–10.9) years old), of which 48% were male and 52% female. During the period of remote monitoring 1062 remote consultations were concluded as follows: 12% via videoconferencing, 64% via audio, and 34% via specialized mobile app. The duration of consultations averaged as follows: 14.9, 20.7 and 14.8 minutes for consultations via videoconferencing, audio and mobile app, respectively. Glycated hemoglobin (HbA1c) level was one of the main indicators for evaluating the effectiveness of participation of children with DM1 in the program of remote observation and education. HbA1c values decreased statistically significantly by the end of the study by –5.0% (p<0.001). As a result, there was a statistically significant (p<0.001) (+55%) increase in the number of children with HbA1c level of less than 7%, thus, most of the children reached the target indicators of glycemic control. In addition to indicators of glycemic control, indicators of the quality of life and the level of distress in parents of children with DM1 were analyzed using specialized questionnaires as supplemental criteria reflecting the clinical effectiveness of remote monitoring. After the first month of participation parents/caretakers showed a statistically significant decrease in the level of stress associated with DM1 in their children (p=0.033), while at the same time the level returned to baseline values (p=0.201) by the end of the project. Conclusion: the outpatient monitoring of children with newly diagnosed DM1 using telemedicine and specialized mobile products (“niche apps”) is an effective (in terms of glycemic control) addition to traditional dispensary monitoring which increases the accessibility of medical care and its convenience to the patients and the quality of life for pediatric patients and their parents/caretakers.

Predictors of burnout and distress in parents of children with autism spectrum disorder during COVID-19 home confinement

ABSTRACT The study’s purpose was to investigate the mental health and related variables of parents with an autism spectrum disorder (ASD) child during COVID-19 home confinement. The study data is based on the evaluation of online self-report questionnaires that assess parental distress, burnout, and coping levels, as well as parent-proxy reports of autism severity and related behavioral issues, as described by the parents of 79 children with ASD and their 83 typically developing age- and sex-matched opponents. The burnout and adaptive coping levels of the parents with ASD children were greater than those of the controls. However, there was no significant difference in terms of general distress levels. Increased irritability was the most commonly reported symptom among children with ASD. However, behavioral issues in children were the strongest predictor of parental burnout, whereas maladaptive coping skills were linked to general distress. This study emphasizes the significance of treating the behavioral issues of children with ASD and the coping strategies of their parents for the mental well-being of this vulnerable population and their parents during home confinement.

Rationale and design of Children’s Oncology Group (COG) study ACCL20N1CD: financial distress during treatment of acute lymphoblastic leukemia in the United States

BackgroundThe study purpose is to describe trajectories of financial distress for parents of children (ages 1–14.9 years) with newly diagnosed acute lymphoblastic leukemia (ALL). The secondary aim is to identify multilevel factors (child, parent, household, treating institution) that influence change in financial distress over time.MethodsThe study uses a prospective cohort design, repeated measurements, and mixed methods. The settings are Children’s Oncology Group (COG) institutions participating in the National Cancer Institute Community Oncology Research Program (NCORP). Eligible participants are English- and/or Spanish-speaking parents or legal guardians (hereafter “parents”) of index children. Parents are asked to complete a survey during their child’s induction (T1) and maintenance therapy (T2), and near treatment completion (T3). Study surveys include items about (a) the child’s cancer and clinical course, (b) parental socio-economic status, financial distress and financial coping behaviors, and (c) household material hardships. At least 15 parents will be invited to participate in an optional semi-structured interview. NCORP institutions that enroll at least one parent must complete an annual survey about institution resources that could influence parental financial distress.DiscussionThe results will inform future interventions to mitigate financial distress for parents of children diagnosed with ALL and could be instructive beyond this disease group.Trial registrationThis trial was initially registered with the NCI Clinical Trial Reporting Program ID: NCI-2021–03,567 on June 16, 2021. The study can be found on clinicaltrials.gov, Identifier NCT04928599.

Stigma, Intrusiveness, and Distress in Parents of Children with a Disorder/Difference of Sex Development.

The impact of parent-reported stigma due to their child's disorder/difference of sex development (DSD) on parent psychosocial adjustment is poorly understood. In other pediatric populations, perceived interference of medical conditions into daily activities (i.e., illness intrusiveness ) mediates the relationship of stigma to adjustment. This study assessed relationships between parent-focused and child-focused stigma → illness intrusiveness → depressive and anxious symptoms . Exploratory analyses sought to identify patient characteristics associated with stigma. Caregivers (59 women and 43 men) of 63 children diagnosed with a DSD up to age 4 years completed measures of demographics, parent-focused and child-focused stigma, illness intrusiveness, and depressive and anxious symptoms. Increased parent-focused and child-focused stigma were associated with increased illness intrusiveness, which, in turn, was associated with increased depressive and anxious symptoms for parents nested within dyads. Among children with DSD family histories, parents reported greater child-focused stigma. Parents who experience DSD-related stigma report greater interference of their child's DSD into their daily activities, which is associated with poorer psychosocial adjustment. Findings support developing clinical interventions related to parents' perceptions of stigma and illness intrusiveness to improve parent adjustment.

Psychological distress in parents of children with autism spectrum disorder: A cross-sectional study based on 683 mother-father dyads

PurposeThis study aimed to assess psychological distress and its gender difference in parents of children with ASD. Predictive factors for parental psychological distress and interaction effects between parents were also explored. Design and methodsA cross-sectional study was conducted for parents of children with ASD and 683 mother-father dyads were included in the analyses. ResultsMothers of children with severe autistic symptoms reported significantly higher levels of stress, anxiety, and depression than fathers. The prevalence of moderate-to-severe anxiety and depression for mothers was 13.8% and 13.1%, respectively. The corresponding prevalence for fathers was 9.9% and 8.0%, respectively. A college education or above protected against maternal stress and an only child predicted paternal stress. Child social impairment predicted maternal but not paternal psychological distress. Stress was a significant predictor of anxiety and depression for both parents. Paternal stress and anxiety moderated the relationship between child's social impairment and maternal stress, and paternal anxiety moderated the relationship between child's social impairment and maternal depression. ConclusionsThe gender difference in the parental psychological distress depends on the severity of children's autistic symptoms. Child social impairment exerts significant effects on mothers' psychological distress and parental stress contributes to anxiety and depression for both parents. The psychological distress of fathers moderates the relationship between child social impairment and maternal psychological distress. ImplicationsHealth-care professionals should pay special attention to parents who are susceptible to psychological distress. Social skill interventions for children and stress reduction programs for parents are recommended to promote parental psychological well-being.

Distress in parents of children undergoing treatment for acute lymphoblastic leukemia

Distress in parents of children undergoing treatment for acute lymphoblastic leukemia

Exploring experiences of psychological distress among Iranian parents in dealing with the sexual behaviors of their children with autism spectrum disorder: a qualitative study.

Sexual behavior is influenced by social and communication deficits in autism spectrum disorder (ASD) and is a serious challenge for parents who lack effective strategies for providing sexual education to their children with ASD. The purpose of this study was to explore Iranian parents' experiences of psychological distress in dealing with the sexual behaviors of their children with ASD. This qualitative study was designed following the conventional content analysis approach. Semi-structured and in-depth interviews were conducted with 27 parents of children with ASD aged 8–34 years. All interviews were audio-recorded and transcribed verbatim. The data were collected through purposeful sampling and continued until data saturation. The worries theme was extracted from data interpretation using qualitative content analysis, and this theme entailed four subthemes: 1) sexual vulnerability, 2) unintended social consequences, 3) psychological suffering, and 4) confusion about the future of a child's sex life. This study emphasized the importance of paying attention to parents' concerns about the sexual behaviors of children with ASD. Parents' psychological distress is a major obstacle to proper coping with sexual behaviors, and using coping strategies may help reduce psychological distress in parents of children with ASD. Therefore, it is necessary to design, implement, and evaluate culture-appropriate educational programs to address parents' concerns regarding the sexual health of a child with autism.

Paving the Way to Promote Resilience in Children With Cancer and Their Families to Overcome Stress and Adversity.

The importance of resilience to combat distress and enhance psychological well-being in children with cancer and their parents is widely recognized. Resilience is defined as an individual’s ability to utilize personal and social resources to maintain psychological well-being and adapt in the face of stress and adversity.1 Our research team has conducted several studies on resilience, with the aim to understand the relationships between resilience, psychological well-being, and quality of life in children with cancer2 and their parents.3,4 Assessing resilience in this cohort is vital to thoroughly understanding their responses to stress and adversity, which is a prerequisite to guide the development of appropriate interventions to enhance their resilience, promote their psychological well-being, and consequently enhance their quality of life. We first conducted a cross-sectional study to examine the relationships between resilience, depressive symptoms, self-esteem, and quality of life in children with cancer.2 The study showed that children with cancer, particularly those from single-parent families, those diagnosed with a brain tumor, and those receiving multiple treatments, reported significantly lower levels of resilience than healthy children. The results also indicated that resilience has a strong positive correlation with quality of life in these children. A cancer diagnosis not only causes considerable stress to children but also negatively affects their parents’ psychological well-being and quality of life.5 Our other study that examined the relationships between resilience and quality of life in parents of children with cancer revealed that parents’ resilience is positively associated with their quality of life.3 The overall results support that parental resilience plays a pivotal role in combating stress or adversities, such as cancer. The results of these studies highlight the importance of assessing the resilience of children with cancer and their parents, while paying special attention to children or parents with low levels of resilience. Most importantly, interventions to enhance the resilience of both children and their parents can facilitate their adjustment to the cancer diagnosis and empower them to overcome adversity throughout the cancer trajectory. These changes can contribute to overall improvement in their psychological well-being and quality of life. For healthcare professionals, a focus on fostering resilience is an important and promising approach to address cancer-related distress in parents of children with cancer. In clinical practice, psychological interventions aimed at enhancing parental resilience should be implemented at an early stage when the parents first learn of their children’s cancer diagnosis. Specifically, evidence-based psychological interventions with a targeted resilience model should be implemented by healthcare professionals to enhance parental resilience4; in turn, this can help the parents to manage their children’s health condition after the cancer diagnosis, better navigate adversity, and consequently improve their psychological well-being. In addition, family-centered resilience enhancement interventions could be considered to simultaneously target the well-being of both children and their parents.

Group engagement in parent-focused telehealth interventions for families of children with type 1 diabetes

Introduction Group engagement is an important component of video-based telehealth interventions, yet this construct remains understudied. In the present study, we applied a multidimensional conceptualization of group engagement in two video-based telehealth interventions that either aimed to reduce fear of hypoglycemia or diabetes distress in parents of children with type 1 diabetes. We examined variability in group engagement across parents and assessed the relationship between parents’ level of group engagement and their treatment outcomes. Methods Twenty-nine parents participated in one of two manualized, closed-group, telehealth interventions and completed outcome measures pre- and post-treatment. We behaviorally coded telehealth sessions based on six dimensions of group engagement using the Group Engagement Measure (inter-rater reliability = 0.94). We examined correlations between group engagement dimensions, parent psychosocial well-being, and child hemoglobin A1c. Further, we examined independent sample t-tests to assess differences between treatment groups. Results Mean parent age was 37.69 ± 6.83 years, mean child age was 7.69 ± 3.76 years, and mean child hemoglobin A1c was 8.06 ± 1.27% (41.4% had a hemoglobin A1c <7.5%). Parents who spent more time attending to other group member's issues, reported lower hypoglycemia fear at post-treatment, and parents who showed more active support of the group leader's purpose/goals during the session also reported fewer depressive symptoms at post-treatment. Discussion We identify several dimensions of group engagement that are associate with improved parent psychosocial and child hemoglobin A1c outcomes. Intervention designs that use group engagement to guide treatment planning or inform treatment-related decisions in video-based telehealth interventions could help families achieve more optimal treatment outcomes.