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.
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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.