Best evidence statement (BESt) Psycho-social interventions for primary caregivers of newly diagnosed pediatric oncology patients
Guideline Developer(s)
Cincinnati Children's Hospital Medical Center
Date Released
Full Text Guideline
Evidence Supporting the Recommendations
Askins MA, Sahler OJ, Sherman SA, Fairclough DL, Butler RW, Katz ER, Dolgin MJ, Varni JW, Noll RB, Phipps S. Report from a multi-institutional randomized clinical trial examining computer-assisted problem-solving skills training for English- and Spanish-speaking mothers of children with newly diagnosed cancer. J Pediatr Psychol. 2009 Jun;34(5):551-63. PubMed
McCarthy PG, Sebaugh JG. Therapeutic scrapbooking: a technique to promote positive coping and emotional strength in parents of pediatric oncology patients. J Psychosoc Oncol. 2011 Mar;29(2):215-30. PubMed
Meyler E, Guerin S, Kiernan G, Breatnach F. Review of family-based psychosocial interventions for childhood cancer. J Pediatr Psychol. 2010 Nov;35(10):1116-32. PubMed
Othman A, Blunden S, Mohamad N, Mohd Hussin ZA, Jamil Osman Z. Piloting a psycho-education program for parents of pediatric cancer patients in Malaysia. Psychooncology. 2010 Mar;19(3):326-31. PubMed
Othman A, Blunden S. Psychological interventions for parents of children who have cancer: a meta-analytic review. Curr Pediatr Rev. 2009;5(2):118-27.
Pai AL, Drotar D, Zebracki K, Moore M, Youngstrom E. A meta-analysis of the effects of psychological interventions in pediatric oncology on outcomes of psychological distress and adjustment. J Pediatr Psychol. 2006 Oct;31(9):978-88. PubMed
The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).
Implementation of the Guideline
An implementation strategy was not provided.
Audit Criteria/Indicators
Resources
Benefits/Harms of Implementing the Guideline Recommendations
Improved patient and caregiver adaption and coping with serious illness and hospitalization
Not stated
Rating Scheme for the Strength of the Recommendations
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
| It is strongly recommended that… It is strongly recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations). |
| It is recommended that… It is recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
| There is insufficient evidence and a lack of consensus to make a recommendation… | |
Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.
Qualifying Statements
This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.
Methodology
Searches of Electronic Databases
Search Strategy
- Databases searched included Ovid MedLine, Cochrane Library, CINAHL Plus, and PsycInfo.
- Search terms included: pediatric oncology, pediatric cancer, pediatric neoplasms, childhood oncology, childhood cancer, childhood neoplasms, psycho-social care, psycho-social interventions, psychological care, psychological interventions, coping, adjustment, mothers, parents, caregivers.
- Studies were limited to English language articles.
- The search was conducted from January 24, 2012 until July 03, 2012.
Not stated
Weighting According to a Rating Scheme (Scheme Given)
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Review of Published Meta-Analyses
Systematic Review
Not stated
Expert Consensus
Not stated
A formal cost analysis was not performed and published cost analyses were not reviewed.
Peer Review
This Best Evidence Statement has been reviewed against quality criteria by two independent reviewers from the Cincinnati Children's Hospital Medical Center (CCHMC) Evidence Collaboration.
Identifying Information and Availability
Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). Psycho-social interventions for primary caregivers of newly diagnosed pediatric oncology patients. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2012 Nov 28. 6 p. [11 references]
Not applicable: The guideline was not adapted from another source.
Cincinnati Children's Hospital Medical Center
Not stated
Author: Amy R. Sparks BSN, RN, CPHON, Inpatient Hematology/Oncology, Cancer and Blood Disease Institute
Consultant: Mary Ellen Meier MSN, RN, CPN, Center for Professional Excellence and Business Integration; Research and Evidence-Based Practice, EBP Mentor
Conflict of interest declaration forms are filed with the Cincinnati Children's Hospital Medical Center Evidence-based Decision Making (CCHMC EBDM) group. No financial or intellectual conflicts of interest were found.
This is the current release of the guideline.
Electronic copies: Available from the Cincinnati Children's Hospital Medical Center.
Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.
The following are available:
- Judging the strength of a recommendation. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Jan. 1 p. Available from the Cincinnati Children's Hospital Medical Center Web site.
- Grading a body of evidence to answer a clinical question. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 1 p. Available from the Cincinnati Children's Hospital Medical Center Web site.
- Table of evidence levels. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Feb 29. 1 p. Available from the Cincinnati Children's Hospital Medical Center Web site.
Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.
In addition, suggested process or outcome measures are available in the original guideline document.
None available
This NGC summary was completed by ECRI Institute on January 28, 2013.
This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:
Copies of this Cincinnati Children's Hospital Medical Center (CCHMC) Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of CCHMC's BESt include the following:
- Copies may be provided to anyone involved in the organization's process for developing and implementing evidence-based care guidelines.
- Hyperlinks to the CCHMC website may be placed on the organization's website.
- The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents.
- Copies may be provided to patients and the clinicians who manage their care.
Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked to by a given organization and/or user, is appreciated.
Scope
Anxiety, emotional distress, post-traumatic stress symptoms, and negative mood due to pediatric cancer
Management
Family Practice
Oncology
Pediatrics
Psychiatry
Psychology
Advanced Practice Nurses
Nurses
Physician Assistants
Physicians
Psychologists/Non-physician Behavioral Health Clinicians
Social Workers
To evaluate, among primary caregivers of newly diagnosed pediatric oncology patients, if caregiver-focused psycho-social interventions compared with current treatment leads to improved patient and caregiver adaption to serious illness and hospitalization when started during initial patient treatment
Primary caregivers of the pediatric oncology patient, which may include parents, step-parents, grandparents, guardians, and/or foster parents
Psycho-social interventions of cognitive behavioral therapy or psycho-educational therapy
Patient and caregiver adaption to serious illness and hospitalization including reduction of anxiety, emotional distress, post-traumatic stress symptoms, mood, and enhanced coping skills and adjustment
Recommendations
The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1aâ5b) are defined at the end of the "Major Recommendations" field.
It is strongly recommended that primary caregivers of newly diagnosed pediatric oncology patients receive psycho-social interventions of cognitive behavioral therapy or psycho-educational therapy to reduce anxiety, emotional distress, post-traumatic stress symptoms, and negative mood and enhance effective coping skills and adjustment (Meyler et al., 2010 [1b]; Othman & Blunden, 2009 [1b]; Pai et al., 2006 [1a]; Askins et al., 2009 [2a]; Othman et al., 2010 [3a]; McCarthy & Sebaugh, 2011 [4b]).
Definitions:
Table of Evidence Levels
| Quality Level | Definition |
|---|---|
| 1a† or 1b† | Systematic review, meta-analysis, or meta-synthesis of multiple studies |
| 2a or 2b | Best study design for domain |
| 3a or 3b | Fair study design for domain |
| 4a or 4b | Weak study design for domain |
| 5a or 5b | General review, expert opinion, case report, consensus report, or guideline |
| 5 | Local Consensus |
†a = good quality study; b = lesser quality study
Table of Language and Definitions for Recommendation Strength
| Language for Strength | Definition |
|---|---|
| It is strongly recommended that… It is strongly recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations). |
| It is recommended that… It is recommended that… not… | When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens. |
| There is insufficient evidence and a lack of consensus to make a recommendation… | |
Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.
None provided
Institute of Medicine (IOM) National Healthcare Quality Report Categories
Getting Better
Living with Illness
Effectiveness
Patient-centeredness
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