| BACKGROUNDThe incidence of cancer in children in China is increasing year by year,and with the increasing progress of diagnosis and treatment technology,the 5-year survival rate of children with cancer has greatly improved.As long-term caregivers of children,parents bear huge mental and economic pressure,and very easy to produce post-traumatic stress disorder,depression and other psychological health problem,which damage the physical and mental health of parents,and even affect the physical and mental health,treatment effect and prognosis of children.Therefore,paying attention to the negative emotions and psychological trauma of parents of children with cancer,early prevention and proper treatment of parents’ mental health problems should become an indispensable link in the system of diagnosis and treatment of children with cancer.Self-compassion is an important protective factor for individual mental hea lth,and the Mindful self-compassion(MSC)has a good effect on improving ps ychological health.However,the relationship between self-compassion and PTS D and the mechanism of action of parents of children with cancer in China are still unclear,and the development form of MSC intervention program suitable for parents of children with cancer in China still needs to be discussed.OBJECTIVE(1)The purpose of this study was to investigate the level of self-compassion among parents of children with cancer in China,and to analyze the relationship between parental self-compassion and PTSD and its mechanism;(2)Develop an Internet-based self-help MSC intervention program suitable for parents of children with cancer in China,and through expert review,qualitative interviews to evaluate and improve the program;(3)Exploring the feasibility and effectiveness of the Internet-based self-help MSC intervention program,so as to provide a scientific and feasible intervention program for improving the level of self-compassion of parents of children with cancer in China,improving negative emotions and health problems,and to provide a scientific reference for the intervention and management of PTSD.METHODS(1)Questionnaire survey:Applying convenience sampling method to selected 227 parents of children with cancer who were treated in 3 hospitals in Guangzhou as respondents to investigate the status of self-compassion of parents of children with cancer,and analyze its correlation with PTSD,post-traumatic growth and depression.(2)Overviews of Reviews:Systematic retrieval of systematic reviews and met a-analysis of the effects of mindfulness meditation on the treatment of PTSD.The AMSTAR 2 scale was used to evaluate the methodological quality of the included studies,and the GRADE system was used to evaluate the outcome in dicators of the included studies.Summarize the existing problems and evaluate the quality of evidence in the current mindfulness meditation-related interventi ons,so as to provide reference for the later implementation of relevant interve ntions.(3)Expert consultation method:This study collected the evaluation results and modification suggestions of 5 experts on the safety,scientificity and feasibility of the Internet-based self-help MSC intervention program through the form of email,and to improve the program.(4)Semi-structured interview method:Interview 21 parents of children with cancer and relevant medical and health care workers about the feasibility of implementing the internet-based self-help MSC intervention program,to understand the possible promotion and hindrance factors encountered in the implementation process of the program,and to modify the program according to the interview results.And,the parents who completed 2/3 of the intervention course were selected for semi-structured interviews after the implementation of the intervention,so as to deeply understand the effect of the internet-based self-help MSC intervention program and the reasons and motivations for parents to insist on completing the program.(5)Experimental research method:34 parents of children with cancer were recruited for the 6-week Internet-based guided self-help MSC intervention program.After the intervention,we used the Chinese version of the Self-Compassion Scale,the Chinese version of the PTSD Civilian version of the screening questionnaire,the Chinese version of the Post-Traumatic Growth Scale,Depression Scale and Pittsburgh Sleep Quality Index to evaluate the effect of intervention.RESULTS(1)Investigation on the level of self-compassion and related factors among parents of children with cancerThe total self-compassion score M(QR)of the parents of children with cancer was 18.75(2.70),which is at a medium level.Parental self-compassion was moderately negatively correlated with PTSD symptoms(r=-0.551,P<0.01),weakly positively correlated with post-traumatic growth(r=0.377,P<0.01),and moderately negatively correlated with depression(r=-0.500,P<0.01).(2)Construction and Improvement of the Internet-based self-help MSC intervention programA Internet-based self-help MSC intervention program with a total of 24 courses for 6 weeks has been formed.Five experts rated the scientificity,safety and feasibility of each course content of the program.The average scientificity score of all courses was 5.0 points,the average safety score was 5.0 points,and the average feasibility score was 4.97 points.And the feasibility of the curriculum setting of the intervention program is scored,the average score is 4.83 points.Indicating that the internet-based self-help MSC intervention program has high scientificity,safety and feasibility.Based on Green’s model,we analyze the facilitating factors and obstacle factors that parents of cancer children and medical and health care workers will perceive during the implementation of the internet-based self-help MSC intervention program.The facilitating factor is benefits for intervention,and that both parents and health care workers agree that the parents of children with cancer need psychological support in order to better take care of their children.The main obstacles include parents not having their own time,ignoring their own psychological needs,resisting to open their hearts,distrusting researchers,and worrying about the side effects of intervention;Moreover,At present,the paediatric ward lacks professional psychological staff and the medical staff are too busy to give psychological support.While the effect of online self-help learning is difficult to guarantee;The incomprehension and non-support of other family members are also important reasons hindering participation;Meanwhile,the child’s treatment situation can affect parents’ arrangement and mood and energy for other activities.(3)Effectiveness verification of the Internet-based self-help MSC intervention program among parents of children with cancerAfter the intervention,the parents’ total SCS-C ’score were increased,and the difference was statistically significant(t=-2.620,P=0.017),while the total PSQI score were decreased,and the difference was statistically significant(Z=-3.632,P<0.001);After completing the intervention,the total scores of PCL-C and PHQ-9 of parents were decreased,while the total scores of PTGI were increased,but the difference was not statistically significant.According to the qualitative data analysis of 9 parents who completed the intervention,the Internet-based self-help MSC course can help parents feel relaxed,reduce stress,adjust negative emotions,learn to grasp the present moment and care for themselves,and improve sleep condition and family relationship.The contract formed in the early stage and the intervention effect experienced were important factors to urge parents to persist in completing the intervention;Not having one’s own time was the main factor hindering parents from completed the intervention course.CONCLUSIONS(1)The self-compassion of parents of children with cancer is at a moderate level.Medical staff should actively carry out targeted self-compassion intervention to improve the level of parental self-compassion,relieve their stress symptoms and negative emotions,promote post-traumatic growth,and improve the quality of life of children and parents.(2)The Internet-based self-help MSC intervention program constructed in this study is feasible and scientific.(3)The Internet-based self-help MSC intervention can effectively improve the self-compassion level of parents of children with cancer and improve sleep quality. |
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