uu.seUppsala universitets publikasjoner
Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Internet-based guided self-help for parents of children on cancer treatment: A randomized controlled trial
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. (Barnonkologisk forskning/Ljungman)
Vise andre og tillknytning
2015 (engelsk)Inngår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 24, nr 9, s. 1152-1158Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective

The aim of the study was to investigate the feasibility and preliminary efficacy of an Internet-based guided self-help intervention for posttraumatic stress symptoms (PTSS) and related symptoms in parents of children on cancer treatment.

Methods

Parents of children on cancer treatment, who fulfilled the modified symptom criteria on the PTSD Checklist, were randomly allocated to the intervention or to a wait-list control condition. The intervention group accessed a 10-week guided self-help program via the Internet based on principles from cognitve behavior therapy. The primary outcome PTSS and the secondary outcomes depression and anxiety were assessed by self-report preintervention and postintervention.

Results

Seven hundred forty-seven parents were approached and informed about the study, 92 were assessed for eligibility, and 58 were included and randomized to the intervention (n = 31) or wait list (n  = 27). Eightteen participants completed the intervention. Intention-to-treat analyses indicated a significant effect of the intervention on PTSS with a large between-group effect size at postassessment (Cohen's d = 0.88). The intervention group reported reductions in PTSS with a large within-group effect size (d = 1.62) compared with a minimal reduction in the wait-list group (d  = 0.09). There was a significant intervention effect on depression and anxiety and reductions in the intervention group with large within-group effect sizes (d = 0.85–1.09).

Conclusions

Findings indicate a low enrollment rate and considerable attrition but also that Internet-based guided self-help shows promise for parents of children on cancer treatment who report a high level of PTSS and would like to take part in an Internet-based intervention.

sted, utgiver, år, opplag, sider
2015. Vol. 24, nr 9, s. 1152-1158
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-234503DOI: 10.1002/pon.3788ISI: 000360992900022PubMedID: 25728688OAI: oai:DiVA.org:uu-234503DiVA, id: diva2:756877
Forskningsfinansiär
Swedish Research Council, K2008-70X-20836-01-3 K2011-70X-20836-04-4Swedish Cancer Society, 2010/276Swedish Childhood Cancer Foundation, PROJ08/010 PRO12/028Tilgjengelig fra: 2014-10-20 Laget: 2014-10-20 Sist oppdatert: 2017-12-05bibliografisk kontrollert
Inngår i avhandling
1. Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
Åpne denne publikasjonen i ny fane eller vindu >>Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
2014 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Having a child diagnosed with cancer is stressful and many parents of children on treatment for cancer report symptoms of posttraumatic stress (PTSS). The overall purpose was to, among parents of children on treatment for cancer, investigate the factor structure of PTSS; investigate the relationships between experiential avoidance (EA), rumination, PTSS and depression; and to develop, test, and evaluate a guided self-help intervention provided via the internet.

In a longitudinal study with three assessments (n = 249-203) results indicated that a four-factor solution of PTSS including the factors re-experiencing, avoidance, dysphoria, and hyper-arousal provided best fit and that the pattern and size of factor loadings were equivalent across the three assessments (Study I). In a case study with pre-, post-, and follow-up assessments a guided self-intervention was well received with clinical significant and reliable improvements in PTSS, depression, and quality of life (Study II). Furthermore, in cross-sectional analyses (n = 79) EA and rumination were positively associated with PTSS and depression and provided incremental explanation in depression while controlling for demographic characteristics, anxiety, and PTSS. In longitudinal analyses (n = 20), EA but not rumination predicted PTSS and depression while controlling for initial levels (Study III). Finally, in a randomized controlled trial with parents fulfilling the modified symptom criteria on the PTSD-Checklist allocated to guided self-help via the internet (n = 31) or to a wait-list control condition (n = 27) there was a significant intervention effect with a large effect size for the primary outcome PTSS. Similar results were observed for the secondary outcomes depression and anxiety, but not for EA and rumination. Exploratory analyses suggested that the relationships between EA and PTSS and between EA and depression were weakened in the intervention group (Study IV).

The studies included in the current thesis suggest that a four-factor solution should be used when assessing PTSS in parents of children on cancer treatment. Furthermore, rumination and EA in particular seem to be important constructs to consider when understanding PTSS and depression in this population. Finally, guided self-help via the internet shows promise in reducing PTSS and depression among parents of children on cancer treatment who report a high level of PTSS.

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2014. s. 65
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1051
Emneord
Cancer and oncology, Children, Parents, Cognitive behavior therapy, Experiential avodiance, Posttraumatic stress symptoms, Depresssion
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-234518 (URN)978-91-554-9098-0 (ISBN)
Disputas
2014-12-18, Room IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2014-11-26 Laget: 2014-10-20 Sist oppdatert: 2015-02-03

Open Access i DiVA

fulltext(415 kB)458 nedlastinger
Filinformasjon
Fil FULLTEXT01.pdfFilstørrelse 415 kBChecksum SHA-512
d0015fcb3985688cad82f052d99f2946a6d4622c1367da58b0f5ed5aa2dc5207b62bbbecc18028f55b35c1b74dd0a3160aa985f7bd45c61374e06318a307f01b
Type fulltextMimetype application/pdf

Andre lenker

Forlagets fulltekstPubMed

Personposter BETA

Cernvall, MartinLjungman, LisaLjungman, Gustafvon Essen, Louise

Søk i DiVA

Av forfatter/redaktør
Cernvall, MartinLjungman, LisaLjungman, Gustafvon Essen, Louise
Av organisasjonen
I samme tidsskrift
Psycho-Oncology

Søk utenfor DiVA

GoogleGoogle Scholar
Totalt: 458 nedlastinger
Antall nedlastinger er summen av alle nedlastinger av alle fulltekster. Det kan for eksempel være tidligere versjoner som er ikke lenger tilgjengelige

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 1232 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf