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. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21NR010103-01A2
Application #
7469878
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Jett, Kathleen
Project Start
2008-05-01
Project End
2010-04-30
Budget Start
2008-05-01
Budget End
2009-04-30
Support Year
1
Fiscal Year
2008
Total Cost
$198,895
Indirect Cost
Name
Oklahoma State University Stillwater
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
049987720
City
Stillwater
State
OK
Country
United States
Zip Code
74078
Fedele, David A; Hullmann, Stephanie E; Chaffin, Mark et al. (2013) Impact of a parent-based interdisciplinary intervention for mothers on adjustment in children newly diagnosed with cancer. J Pediatr Psychol 38:531-40
Mullins, Larry L; Fedele, David A; Chaffin, Mark et al. (2012) A clinic-based interdisciplinary intervention for mothers of children newly diagnosed with cancer: a pilot study. J Pediatr Psychol 37:1104-15