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Cognitive-Behavioral Intervention for Children With Hematological Cancer Receiving Chemotherapy: A Randomized
Tenaw Gualu Melesse1,2, William Ho Cheung Li1, Janita Pak Chun Chau1
1The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Insights
Cognitive-behavioral intervention (CBI) significantly reduced anxiety and depression while improving quality of life in Ethiopian children with hematological cancer. These findings support integrating CBI into pediatric cancer care.
Area of Science:
- Pediatric Oncology
- Clinical Psychology
- Hematology
Background:
- Cognitive-behavioral intervention (CBI) is effective for psychological outcomes in pediatric cancer patients.
- No prior evidence of CBI effectiveness existed in Ethiopia.
- This study addresses a critical gap in supportive care for Ethiopian children with cancer.
Purpose of the Study:
- To evaluate the impact of CBI on anxiety, depression, and quality of life (QoL).
- To assess the efficacy of CBI in Ethiopian children undergoing chemotherapy for hematological cancers.
Main Methods:
- A randomized controlled trial (RCT) involving 76 children with hematological cancer.
- Participants were assigned to either CBI or standard medical care.
- CBI consisted of five weekly 30-40 minute sessions focusing on cognitive and behavioral strategies.
Main Results:
- The CBI group demonstrated significant reductions in anxiety and depression scores post-intervention.
- Quality of life significantly improved in the CBI group at one month post-intervention.
- Statistical significance was observed at p < 0.001 for anxiety and p < 0.005 for depression.
Conclusions:
- CBI is effective in alleviating anxiety and depression and enhancing QoL in pediatric hematological cancer patients.
- Integration of CBI into pediatric hematology-oncology settings is recommended.
- Further research on long-term effects and cost-effectiveness of CBI is warranted.
Objective:
Cognitive-behavioral intervention (CBI) has shown positive effects in improving psychological and health-related outcomes in children with cancer. However, no evidence has been found in Ethiopia. This study aimed to evaluate the effects of CBI on anxiety, depression and quality of life (QoL) in Ethiopian children with hematological cancer receiving chemotherapy.
Methods:
A parallel, two-armed, assessor-blinded, randomized controlled trial was conducted among 76 children randomized (1:1) to receive CBI or usual medical care. The intervention group received five weekly face-to-face CBI sessions of 30-40 min each, which included an introduction to CBI; identifying and challenging maladaptive thoughts, beliefs and behavior; behavior activation; deep breathing exercises; and treatment evaluation and relapse prevention. The outcomes were measured at baseline (T0), immediately post-intervention (T1) and 1 month post-intervention (T2).
Results:
The intervention group showed a significant reduction in anxiety scores from T0 at T1 (β = -6.67, 95% CI [-9.16, -4.19], p < 0.001) and T2 (β = -8.14, 95% CI [-10.70, -5.57], p < 0.001), depression at T1 (β = -4.09, 95% CI [-6.94, -1.23], p = 0.005) and T2 (β = -6.12, 95% CI [-9.10, -3.13], p < 0.001) and improvement in QoL at T2 (β = 3.02, 95% CI [0.49, 5.56], p = 0.019) compared with the control group.
Conclusions:
CBI has positive effects in reducing anxiety and depression and in improving QoL in children with hematological cancer receiving chemotherapy. The results suggest the need to incorporate CBI into pediatric hematology-oncology and studies on its long-term effects and cost-effectiveness are warranted.
Trial Registration:
ClinicalTrials.gov (NCT05270655). Registered on 08 March 2022.
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