Feasibility of a Couple-based Intervention for Parents of Children with Cancer

描述(由申请人提供)：有癌症孩子的夫妇从确诊到存活都面临着多重和普遍的压力。他们必须处理自己和孩子的情绪困扰，并在平时的责任和孩子生病时施加的责任之间进行权衡。生下患癌症的孩子会让夫妻关系紧张，并可能导致感情破裂。此外，父母作为夫妇对孩子癌症的反应方式可能最终会影响到每个父母、孩子和家庭系统的调整。尽管在儿童癌症的背景下，夫妻关系的重要性，但到目前为止，还没有关于对患有癌症儿童的父母进行基于夫妇的干预的研究。这项拟议的研究评估了一种新开发的、基于认知行为的夫妇干预的可行性和初步效果。参与者将是30对夫妇，他们的孩子被诊断为癌症，正在接受治疗。夫妻将被随机分配到基于夫妻关系增进干预或教育/支持控制条件的2：1分配，这两种情况都将包括六个小时，一小时 基于电话的会议。以夫妻为基础的关系增进干预将为夫妇提供有效的关系技能培训，以有效沟通和解决与照顾患有癌症的孩子、维持自己的夫妇关系以及作为个体相互支持相关的问题。这项研究的主要目的包括确定基于伴侣的关系增强是否可行并为夫妇所接受，以及与注意控制条件相比，它是否会导致他们的关系功能、双方的个人功能和父母功能的改善。还将评估对儿童和家庭功能的影响。在治疗前后进行的评估将包括夫妇对他们的关系功能、个人心理健康、父母功能、孩子健康和整体家庭功能的报告，以及将根据伴侣支持和沟通技能的维度对与癌症有关的对话录音进行评级。这项研究的发现有可能导致创建一种有效的干预措施，从而改善夫妇和家庭对儿童癌症的适应。如果成功，我们将提出包括长期随访在内的后续更大规模的随机对照试验。 公共卫生相关性：孩子患有癌症的夫妇从确诊到存活都面临着多重和普遍的压力。尽管夫妇在家庭适应儿童癌症方面发挥着核心作用，但到目前为止，还没有关于以夫妇为基础的干预儿童癌症的研究。这项研究可能会显著提高我们对如何帮助夫妇扮演重要角色的理解，因为他们作为夫妇、个人和父母，在适应生下患有癌症的孩子的过程中发挥着重要作用。

DESCRIPTION (provided by applicant): Couples who have a child with cancer are faced with multiple and pervasive stressors from the time of diagnosis through survivorship. They must deal with their own emotional distress as well as that of their children, and juggle their usual responsibilities with those imposed by the child's illness. Having a child with cancer strains couples' relationships and can lead to relationship distress. Moreover, the way in which parents respond as a couple to the child's cancer may ultimately impact the adjustment of each parent, the child, and the family system. Despite the importance of couple functioning in the context of childhood cancer, to date there have been no studies of couple-based interventions for parents of children with cancer. The proposed study evaluates the feasibility and preliminary efficacy of a newly developed, cognitive-behavioral couple-based intervention. Participants will be 30 couples whose children are being treated for a first diagnosis of cancer. Couples will be randomly assigned with a 2:1 allocation to the Couple-Based Relationship Enhancement intervention or an Education/Support control condition, both of which will consist of six, one-hour telephone-based sessions. The Couple-Based Relationship Enhancement intervention will provide couples with training in well-validated relationship skills to communicate effectively and problem-solve about issues related to caring for their child with cancer, maintaining their own couple's relationship, and supporting each other as individuals. The primary aims of the study involve determining whether the Couple-Based Relationship Enhancement is feasible and acceptable to couples, and whether it will lead to improvements in their relationship functioning, individual functioning for both partners, and parental functioning compared to the attention control condition. The impact on child and family functioning will also be assessed. Assessments conducted before and after treatment will include couples' reports of their relationship functioning, individual psychological well-being, parental functioning, child well-being, and overall family functioning, along with audio recorded cancer-related conversations that will be rated on dimensions of partner support and communication skills. Findings from this study have the potential to result in the creation of an effective intervention that will lead to improved couple and family adjustment to childhood cancer. If successful, we will propose a subsequent, larger RCT that includes long-term follow-up. PUBLIC HEALTH RELEVANCE: Couples who have a child with cancer are faced with multiple and pervasive stressors from the time of diagnosis through survivorship. Despite the central role that couples play in families' adjustment to childhood cancer, to date there has been no studies of couple- based interventions for pediatric cancer. This study might significantly improve our understanding of how to assist couples in important roles that they fulfill as a couple, individual, and parents, as they adapt to having a child with cancer.