Randomized Trial of a Supportive Psychotherapy for Parents of Adolescents and Young Adults With Hematologic Malignancies
Gesundheitscampus Immunologie, Infektiologie und Inflammation (GCI3), Medical Center
Search for other papers by Michael Koehler in
Current site
Google Scholar
PubMed
Gesundheitscampus Immunologie, Infektiologie und Inflammation (GCI3), Medical Center
Search for other papers by Susanne Hoppe in
Current site
Google Scholar
PubMed
Search for other papers by Siegfried Kropf in
Current site
Google Scholar
PubMed
Search for other papers by Anke Lux in
Current site
Google Scholar
PubMed
Gesundheitscampus Immunologie, Infektiologie und Inflammation (GCI3), Medical Center
Search for other papers by Rainer Bartsch in
Current site
Google Scholar
PubMed
Search for other papers by Bernhard Holzner in
Current site
Google Scholar
PubMed
Search for other papers by Juergen Krauter in
Current site
Google Scholar
PubMed
Search for other papers by Axel Florschütz in
Current site
Google Scholar
PubMed
Search for other papers by Kathleen Jentsch-Ullrich in
Current site
Google Scholar
PubMed
Search for other papers by Joerg Frommer in
Current site
Google Scholar
PubMed
Search for other papers by Hans-Henning Flechtner in
Current site
Google Scholar
PubMed
Gesundheitscampus Immunologie, Infektiologie und Inflammation (GCI3), Medical Center
Search for other papers by Thomas Fischer in
Current site
Google Scholar
PubMed
Background: Cancer regularly disrupts health and developmental trajectories in adolescents and young adults (AYAs). Parents have been shown to have a substantial impact on the health and cancer survivorship activities of AYA patients in the form of symptom management. However, no randomized controlled trial has evaluated a coping support intervention (CSI) program for parents of AYAs with cancer aged 18 to 40 years. Patients and Methods: From November 30, 2012, to August 29, 2016, parents of AYAs with hematologic malignancies were randomized in a phase III controlled trial (1:1 ratio, stratified sampling) to either the research-based CSI AYA-Parents group (CSI group; n=82) or the standard care (SC) group (n=70). CSI consisted of 5 sessions to achieve the enhancement of parental adaptive coping as the primary outcome (per the adaptive coping scale of the 28-item Brief COPE, a validated multidimensional self-assessment-questionnaire recommended for clinical cancer research). Measures of adaptive coping, depression, and mental health were collected at pre-CSI (measurement date T1), at the end of the intervention sessions (measurement date T2), and at follow-up (3 months). We calculated mean change scores in outcomes and estimated intervention effect sizes (Cohen’s d) for changes from T1 to T2/T3, with 0.2 indicating a small effect, 0.5 a medium effect, and 0.8 a large effect. All statistical tests were 2-sided. Results: In the intention-to-treat analysis, the CSI group significantly improved their adaptive coping compared with the SC group (95% CI, 0.30–2.54; P=.013; d=0.405), whereas adaptive coping in the SC group deteriorated. The CSI group also experienced a significant decrease in depressive symptoms and improved mental health with clinical significance (95% CI, –1.98 to –0.30; P=.008; d=0.433, and 95% CI, –0.19 to 3.97; P=.074; d=0.292, respectively). Sensitivity analyses confirmed the robustness of the main intention-to-treat analysis. Conclusions: CSI improved effectively adaptive coping and depression in parents of AYAs with hematologic malignancies. It may represent a novel family-based approach in AYA oncology care.
Submitted November 8, 2020; final revision received May 21, 2021; accepted for publication June 17, 2021. Published online April 11, 2022.
Previous presentation: This work was previously presented as an oral abstract at the 33rd German Cancer Congress; February 21–24, 2018; Berlin, Germany. Abstract 550.
Author contributions: Study concept and design: Koehler, Kropf, Frommer, Flechtner, Fischer. Data curation: Koehler, Hoppe, Kropf, Lux, Bartsch, Holzner, Krauter, Florschütz, Jentsch-Ullrich. Formal data analysis and interpretation: Koehler, Hoppe, Kropf, Lux. Data interpretation: Koehler, Hoppe, Kropf, Lux, Frommer, Flechtner, Fischer. Manuscript writing—original draft: Koehler, Hoppe, Fischer. Manuscript writing—review and editing: All authors.
Disclosures: Dr. Holzner has disclosed holding intellectual property rights on the CHES software tool used for data collection. The remaining authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: This work was funded by German Cancer Aid (grant number 109965).
Disclaimer: The funder had no role in the design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Supplementary Materials
- Supplemental Materials (PDF 6.07 MB)
© 2019-2024 National Comprehensive Cancer Network