A Clinic-Based Interdisciplinary Intervention for Parents of Children with Cancer

描述（由申请人提供）：儿童癌症的影响具有全系统的影响，从诊断到生存，儿童及其父母都面临着适应受损的风险。在儿童癌症诊断后，父母是孩子的主要照顾者，因此，他们不仅在适应孩子的诊断方面面临着巨大的困难，而且在艰难而漫长的治疗过程中也面临着巨大的困难。迄今为止，只有少数研究试图评估全面的社会心理干预对癌症儿童父母的益处。这些新出现的文献表明，社会心理干预确实有可能促进应对努力和改善父母的心理困扰，并且在儿童诊断后不久进行的干预可能优于治疗后进行的干预。因此，目前的项目是一项试点研究，将评估为新诊断为癌症的儿童的父母实施基于临床的跨学科（心理学和护理）干预的可行性和可接受性。家长将在基线时被随机分配到跨学科干预组（IG）或常规治疗组（TAU）。6个模块，12个课程的跨学科干预将侧重于教授父母帮助他们管理不确定性的技能。干预将会隔周进行，由一名心理临床医生进行6次临床治疗，在两次临床治疗之间由一名护理干预师进行6次电话治疗。本研究的主要目的是：1)评估对新诊断为癌症的儿童的父母实施12期、基于临床的跨学科干预的可行性和可接受性；2)评估干预在减轻父母心理困扰、创伤后应激症状、照顾者负担和疾病不确定性方面的效应量。其次，探索目的包括：1)评估疾病不确定性是否介导干预对父母心理困扰、创伤后应激障碍和照顾者负担的影响；2)评估干预是否对儿童的情绪和行为功能产生间接影响。父母将在三个时间点完成心理困扰、创伤后应激障碍、照顾者负担、疾病不确定性以及孩子的情绪和行为功能的测量：基线、治疗后1个月和3个月。公共卫生相关性：目前的研究是一项干预，旨在帮助减少父母因孩子最近被诊断出癌症而产生的痛苦。干预将包括心理学家和护士的专业知识，教父母如何帮助他们管理对孩子疾病的不确定性。

DESCRIPTION (provided by applicant): The impact of pediatric cancer exerts system-wide influences, which places both children and their parents at risk for compromised adjustment from the time of diagnosis through survivorship. Parents serve as primary caregivers for their child following the diagnosis of pediatric cancer, and as such, they face substantial difficulties in not only adjusting to their child's diagnosis, but also in negotiating an arduous and lengthy treatment course. To date, only a handful of studies have sought to evaluate the benefits of comprehensive psychosocial interventions for parents of children with cancer. This emerging literature suggests that psychosocial interventions indeed have the potential to promote coping efforts and ameliorate psychological distress in parents, and that interventions taking place soon after the child's diagnosis may be superior to those that occur post-treatment. Thus, the current project is a pilot study that will assess the feasibility and acceptability of implementing a clinic-based interdisciplinary (psychology and nursing) intervention for parents of children newly diagnosed with cancer. Parents will be randomly assigned at baseline to either the interdisciplinary intervention group (IG) or the treatment as usual (TAU) group. The 6-module, 12-session interdisciplinary intervention will focus on teaching parents skills to help them manage their uncertainty. The intervention will alternate weeks with 6 in-clinic sessions delivered by a psychology clinician, coupled with 6 telephone sessions delivered by a nurse interventionist in between the clinic sessions. The current study is guided by the following primary aims: 1) to assess the feasibility and acceptability of implementing a 12-session, clinic-based, interdisciplinary intervention for parents of children newly diagnosed with cancer; 2) to estimate effect sizes for the intervention in reducing parental psychological distress, posttraumatic stress symptoms (PTSS), caregiver burden, and illness uncertainty. Secondary, exploratory aims include: 1) to assess whether illness uncertainty mediates the effect of the intervention on parent psychological distress, PTSS, and caregiver burden; and 2) to assess whether the intervention exerts an indirect effect on the child's emotional and behavioral functioning. Parents will complete measures of psychological distress, PTSS, caregiver burden, illness uncertainty, and their child's emotional and behavioral functioning at three time points: baseline, and 1-month, and 3-months post-treatment. PUBLIC HEALTH RELEVANCE: The current study is an intervention designed to help reduce parents' distress associated with their child's recent diagnosis of cancer. The intervention will include the expertise of both psychologists and nurses in teaching parents skills to help manage their uncertainty about their child's illness.