Effectiveness of a mobile-based resilience training programme in enhancing resilience, reducing depressive symptoms and promoting quality of life among Chinese parents of children with cancer : a randomised controlled trial

Abstract

Caring for children with cancer can be a stressful experience for parents and may have negative effects on the parents’ physical and psychological well-being. Although the benefits of resilience on health have been discovered, psychological interventions to enhance resilience and promote well-being in parents of children with cancer remain relatively underexplored.

The aims of the thesis were fourfold: (1) examine the relationship between resilience and quality of life; (2) summarise the characteristics of current psychological interventions to promote resilience; (3) identify the factors that facilitate or hinder resilience; and (4) evaluate the effectiveness of a mobile-based resilience training programme in enhancing resilience, reducing depressive symptoms and promoting quality of life among Chinese parents of children with cancer.

Before the intervention study, existing evidence to promote resilience was synthesised in a systematic review and meta-analysis, and two descriptive studies were conducted to understand resilience and its relationship with quality of life in Chinese parents of children with cancer. A culturally adjusted resilience training programme was then developed, and its feasibility and acceptability were tested via a pilot study. This was followed by a randomised controlled trial, in which a total of 103 Chinese parents of children who received a diagnosis of cancer within the past year were recruited from three tertiary hospitals in mainland China. These participants were randomly assigned either to the experimental group (n = 52) to undergo an 8-week mobile-based resilience training programme, or to the control group (n = 51) to receive an 8-week programme of placebo information. All participants were required to assess their resilience, depressive symptoms and quality of life at baseline and 2 and 6 months after starting the intervention.

The cross-sectional study showed that the parents with higher levels of resilience reported better quality of life. The qualitative study identified four factors that contributed to the parents’ resilience: attitudes towards and cognition of the children’s disease, coping strategies used, competence in taking care of the sick children and perceived social support. The intervention study revealed that parents in the experimental group reported higher levels of resilience and lower levels of depressive symptoms than those in the control group at the 6-month follow-up. No statistically significant intervention effect was detected for quality of life.

The two descriptive studies provided a thorough understanding of the resilience in Chinese parents of children with cancer. Most importantly, the intervention study addressed a gap in the literature by developing and evaluating the effectiveness of a mobile-based resilience training programme. The results indicated that this programme was effective in enhancing resilience and reducing depressive symptoms among Chinese parents of children with cancer.

The findings further evidence that resilience is of paramount importance for well-being in parents of children with cancer. Healthcare professionals are strongly recommended to incorporate the mobile-based resilience training programme when providing psychological care for parents of children with cancer.