基于群体的多成分心理教育干预对癌症儿童照顾者焦虑、抑郁症状、生活质量和应对的有效性：一项随机对照试验

IF 7.1 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-09-04 DOI:10.1016/j.ijnurstu.2025.105205

Lophina Phiri , Ho William Cheung Li , Patrick G.M.C. Phiri , Kai Chow Choi , Watipaso Wanda-Kalizang'oma , Grace Nkhandwe

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引用次数: 0

摘要

由于癌症的性质和治疗的复杂性，照顾患有癌症的儿童对照顾者来说是一种压力很大的经历，这使他们容易产生负面的心理结果。常见的负面心理结果包括焦虑和抑郁症状。照护者也普遍报告与健康相关的生活质量差和应对能力低下。目的评价基于群体的多成分心理教育干预对癌症治疗儿童照顾者焦虑、抑郁症状、健康相关生活质量和应对的效果。设计一项单盲平行随机对照试验。马拉维两个主要的儿科癌症中心。参与者：正在接受癌症治疗的儿童的照顾者。方法干预组采用每周6次的心理教育干预，对照组采用常规护理。主要结局是焦虑和抑郁症状，次要结局是健康相关的生活质量和应对能力。在基线、干预后立即和干预后3个月进行数据收集。采用广义估计方程对数据进行分析。进行意向治疗分析以尽量减少损耗偏差。结果118名参与者被随机分为干预组（59名）和对照组（59名）。干预组与对照组相比，干预后即刻焦虑水平、抑郁症状、回避性应对均有显著降低，且在随访3个月时效果持续。此外，干预组在干预后和3个月的随访中，与对照组相比，在问题焦点和情绪焦点应对方面表现出更大的改善。然而，在干预后立即与3个月随访时，两组之间在与健康相关的生活质量变化方面没有统计学上的显著差异。结论以群体为基础的多元心理教育干预能有效减轻癌症患儿照顾者的焦虑和抑郁症状，提高其应对能力。护士应考虑以群体为基础的多成分心理教育干预，以提高癌症儿童照顾者的心理健康。该试验已在美国临床试验注册中心注册（NCT05783310）。注册日期：2023年3月13日，首次招聘日期：2023年5月22日。

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Effectiveness of group-based multicomponent psychoeducational intervention on anxiety, depressive symptoms, quality of life, and coping among caregivers of children with cancer: A randomised controlled trial

Background

Caring for a child with cancer is a stressful experience for caregivers because of the nature of cancer and the complexity of treatment, which predisposes them to negative psychological outcomes. Common negative psychological outcomes include anxiety and depressive symptoms. Caregivers also commonly report poor health-related quality of life and dysfunctional coping.

Objective

To evaluate the effectiveness of a group-based multicomponent psychoeducational intervention on anxiety, depressive symptoms, health-related quality of life, and coping among caregivers of children undergoing cancer treatment.

Design

A single-blind parallel randomised controlled trial.

Setting(s)

Two major paediatric cancer centres in Malawi.

Participants

Caregivers of children undergoing cancer treatment.

Methods

The intervention group underwent six weekly sessions of psychoeducational intervention, while the control group received the usual care. The primary outcome was anxiety and depressive symptoms, while secondary outcomes were health-related quality of life and coping. Data collection was conducted at baseline, immediately after the intervention and 3 months afterwards. A generalised estimating equation was used to analyse data. An intention-to-treat analysis was performed to minimise attrition bias.

Results

Overall, 118 participants were randomised to either the intervention group (59) or the control group (59). The intervention group showed a statistically significant reduction in anxiety levels, depressive symptoms, and avoidant coping immediately after the intervention compared with the control group, and the effect was sustained at 3-month follow-up. Furthermore, the intervention group demonstrated greater improvement in problem-focused and emotion-focused coping immediately after the intervention and at 3-month follow-up compared with the control group. However, there was no statistically significant difference between the groups in terms of changes in health-related quality of life immediately after the intervention and at the 3-month follow-up.

Conclusions

The study provides evidence that group-based multi-component psychoeducational intervention is effective in reducing anxiety and depressive symptoms and improving coping among caregivers of children with cancer. Nurses should consider group-based multi-component psychoeducational intervention for enhancing the psychological well-being of caregivers of children with cancer.

Registration

The trial was registered with the United States Clinical Trial Registry (NCT05783310). Registered on 13/03/2023, the first recruitment 22/05/2023.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).