Background: Caregivers of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk for psychological distress. Bright IDEAS®(BI) is an effective and acceptable modification of problem-solving therapy for caregivers of children with new cancer diagnoses, but it has not been tested on caregivers of children undergoing HSCT. This randomized controlled pilot examined the feasibility, acceptability, and preliminary efficacy of BI among caregivers of children undergoing HSCT. Methods: English- and Spanish-speaking caregivers of children aged 2–21 years were recruited within 10 days of their child’s autologous or allogeneic HSCT. Participants were randomized 1:1 to receive six-to-eight individualized BI sessions or usual care. Participants completed self-report measures of psychological distress at enrollment (pre-intervention) and on days 60, 90, and 180 post HSCT. Qualitative interviews were conducted among a subset (N= 7) of intervention completers to assess caregiver perceptions of BI. Results: A total of 107 caregivers were screened for participation; 64 were eligible. Thirty-eight were enrolled (59.4%) and randomized. In the BI group, 14/20 participants (70%) completed six or more sessions. The completion rate for distress measures was at least 78% for both study groups across timepoints. Despite higher baseline scores, caregivers in the BI group reported lower anxiety and depression scores at follow-up timepoints compared to the control group, based on observed trends. Qualitative interviews reflected acceptability of BI. Conclusions: The results support the feasibility and acceptability of BI for caregivers of children undergoing HSCT. A larger efficacy trial of BI in the pediatric HSCT setting is warranted.
背景：接受造血干细胞移植（HSCT）患儿的照顾者面临心理困扰的风险。Bright IDEAS®（BI）是针对新诊断癌症患儿照顾者的一种有效且可接受的问题解决疗法改良方案，但尚未在接受HSCT患儿的照顾者中进行测试。本随机对照试点研究探讨了BI在接受HSCT患儿照顾者中的可行性、可接受性及初步疗效。 方法：在患儿接受自体或异体HSCT后10天内，招募2-21岁患儿的英语或西班牙语照顾者。参与者按1:1比例随机分配，接受6至8次个性化BI干预或常规护理。参与者在入组时（干预前）及HSCT后第60天、90天和180天完成心理困扰的自我报告评估。对部分完成干预的参与者（N=7）进行定性访谈，以评估照顾者对BI的认知感受。 结果：共筛查107名照顾者，其中64名符合条件。38名照顾者（59.4%）入组并完成随机分配。在BI组中，20名参与者中有14名（70%）完成了6次或更多干预。两组参与者在各时间点的心理困扰评估完成率均不低于78%。基于观察趋势，尽管基线评分较高，但BI组照顾者在随访时间点的焦虑和抑郁评分低于对照组。定性访谈结果反映了BI的可接受性。 结论：研究结果支持BI在接受HSCT患儿照顾者中的可行性与可接受性。有必要在儿科HSCT环境中开展更大规模的BI疗效试验。
肿瘤(癌症)患者之家