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1.
J Pediatr Psychol ; 48(3): 216-227, 2023 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-36303445

RESUMO

BACKGROUND: Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cancer Competently Intervention Program (eSCCIP) is a psychosocial eHealth intervention for caregivers, developed using an iterative, user-centered process. METHOD: eSCCIP was tested in a single-arm pilot trial at Nemours Children's Hospital, Delaware (NCT05333601). The primary outcomes were intervention acceptability and feasibility, assessed via enrollment and retention targets, and item-level acceptability ratings. Enrollment and retention targets of 45% were set based on previous work, and an item-level acceptability threshold of 80% was set. A secondary exploratory analysis was conducted examining acute distress, anxiety, symptoms of post-traumatic stress, and family functioning. RESULTS: 44 caregivers enrolled in the study and 31 completed. The intervention was rated favorably by completers, with over 80% of the sample selecting "mostly true" or "very true" for all items of the eSCCIP Evaluation Questionnaire, which was used to assess acceptability and feasibility. Enrollment and retention rates were 54% and 70%, respectively. Exploratory psychosocial outcomes showed statistically significant decreases from pre-intervention to post-intervention for overall symptoms of post-traumatic stress disorder (PTSD), cluster D symptoms of PTSD (negative mood and cognitions), and anxiety. Small-moderate effect sizes were observed for all psychosocial outcomes of interest. CONCLUSIONS: eSCCIP is an acceptable and feasible intervention for caregivers. Results are promising regarding reductions in symptoms of post-traumatic stress and anxiety.


Assuntos
Neoplasias , Transtornos de Estresse Pós-Traumáticos , Criança , Humanos , Ansiedade/terapia , Cuidadores/psicologia , Estudos de Viabilidade , Neoplasias/psicologia , Projetos Piloto , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia
2.
Pediatr Cardiol ; 44(7): 1479-1486, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37355506

RESUMO

Prenatal diagnosis of congenital heart disease (CHD) often leads to anxiety, depression, and traumatic stress in expectant mothers, with long-term implications for the child and family. However, psychosocial intervention is rarely incorporated into prenatal care. HEARTPrep is a virtually delivered psychosocial intervention aimed at reducing distress and social isolation and increasing parenting self-efficacy and hope for mothers expecting a baby with CHD to promote long-term child/family well-being. This study evaluated the feasibility and acceptability of HEARTPrep. Participants were mothers receiving cardiology care for a fetal CHD diagnosis. Partners could participate with the mother. HEARTPrep was delivered through a mobile app and telehealth. Feasibility was assessed through enrollment/retention rates. Acceptability was assessed through 20 Likert-scale and five open-ended questions. Of 39 recruited mothers, 35 (90%) enrolled. Half of partners (48%) also participated. Twenty-seven of 35 enrolled mothers (77%) completed HEARTPrep. On a scale from 0 (Not at All) to 4 (Very), mean item acceptability scores ranged from 3.5 to 3.9. Mothers reported HEARTPrep helped them feel less distressed (mean: 3.74), less alone (3.84), more prepared (3.89), and more hopeful (3.84). Opportunities to process emotions, develop coping skills, learn with their partner, navigate relationships, understand they are not alone, connect with peer support, access resources, and prepare for stressors were described as helpful. HEARTPrep is feasible and acceptable for mothers expecting a baby with CHD. Future research will evaluate its efficacy in preventing/reducing maternal mental health problems and improving postnatal clinical outcomes.


Assuntos
Cardiopatias Congênitas , Intervenção Psicossocial , Feminino , Lactente , Criança , Gravidez , Humanos , Estudos de Viabilidade , Mães , Ansiedade , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/terapia
3.
J Patient Exp ; 11: 23743735241229374, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38414756

RESUMO

User-centered models for the development of digital health interventions are not consistently applied in healthcare settings. This study used a five-phase, user-centered approach to develop HEARTPrep©, a psychosocial intervention delivered via mobile app and telehealth to mothers expecting a baby with congenital heart disease (CHD) to promote maternal, family, and child well-being. Phases of intervention development were: (I) establishing partnerships; (II) creating content; (III) developing prototype and testable intervention; (IV) conducting think-aloud testing; and (V) completing beta testing. Partnerships with parents, clinicians, and design/technology experts were integral throughout the development of HEARTPrep©. Parents of children with CHD also served as participants in Phases II-V, contributing to the creation of content and providing feedback to inform the iterative refinement of HEARTPrep©. These five phases produced a refined digital health intervention with promising feasibility, usability, and acceptability results. This user-centered approach can be used to develop digital health interventions targeting various health outcomes.

4.
Teach Psychol ; 50(3): 264-277, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37337592

RESUMO

Background: The COVID-19 pandemic resulted in an abrupt transition from in-person to online learning in Spring 2020. Objective: The purpose of this study was to identify the impact of the transition on undergraduates during the period following the campus closure. Method: 131 psychology undergraduate students completed an online survey of how the COVID-19 closure had impacted their academics, online learning environment, and traumatic stress symptoms (using the Posttraumatic Stress Disorder Checklist for the DSM-5). Results: Most participants reported increased academic difficulty compared to before closure. Approximately 30% reported elevated traumatic stress symptoms. Greater traumatic stress was associated with greater difficulty completing assignments, more limited access to the internet and quiet places to study, and greater sibling-care responsibilities. Conclusions: The acute transition to online instruction posed academic and emotional challenges to many students, especially those from environments with competing demands or less access to academic supports. Follow-up evaluation is needed to determine whether these difficulties have persisted in subsequent semesters of online instruction. Teaching Implication: Instructors should anticipate the emotional and academic needs of students who are relatively unfamiliar with online instruction and consider ways to minimize negative environmental impacts and increase access to mental health resources.

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