ABSTRACT
This study provides a systematic review and meta-analysis of randomized controlled trials that analyzed the efficacy of psychological interventions for parents of children with cancer. The search was conducted in the databases PsycInfo, Medline, PsycArticles, and PsycTests. Fourteen studies met the inclusion criteria. Two independent researchers extracted relevant data, and the studies were assessed for methodological quality. The standardized mean difference (d) was used as the effect size index. The meta-analyses, which applied random and mixed-effects models, showed that weighted effect sizes were statistically significant for depression at posttreatment (d= 1.19). However, the methodological quality moderated the depression estimate. The weighted effect sizes for the remaining variables were not statistically significant: stress/burnout (d= 0.90), quality of life (d= 1.26), anxiety (d= 0.21), posttraumatic stress (d= 0.05), and general indicator of emotional symptoms (d= 0.33). This review also highlights several methodological limitations of the studies. Future directions for research that examines interventions targeting primary caregivers of children with cancer are discussed. In conclusion, more high-quality research is needed to establish the efficacy of psychological interventions for parents of children with cancer (AU)
Subject(s)
Humans , Neoplasms/psychology , Parents/psychology , Parent-Child Relations , Psychosocial Support Systems , Psycho-Oncology , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: The long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD. METHODS: A randomized controlled, multicentric, double-blind trial was conducted. Children (2-10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan-Meier estimates were calculated. RESULTS: Fifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated. CONCLUSION: This long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.
