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  • Guideline Summary
  • NGC:009492
  • 2012 Nov 28

Best evidence statement (BESt). Psycho-social interventions for primary caregivers of newly diagnosed pediatric oncology patients.

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]

View the original guideline documentation External Web Site Policy

This is the current release of the guideline.

Major Recommendations

The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1a‒5b) 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.

Clinical Algorithm(s)

None provided

Disease/Condition(s)

Anxiety, emotional distress, post-traumatic stress symptoms, and negative mood due to pediatric cancer

Guideline Category

Management

Clinical Specialty

Family Practice

Oncology

Pediatrics

Psychiatry

Psychology

Intended Users

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Psychologists/Non-physician Behavioral Health Clinicians

Social Workers

Guideline Objective(s)

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

Target Population

Primary caregivers of the pediatric oncology patient, which may include parents, step-parents, grandparents, guardians, and/or foster parents

Interventions and Practices Considered

Psycho-social interventions of cognitive behavioral therapy or psycho-educational therapy

Major Outcomes Considered

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

Methods Used to Collect/Select the Evidence

Searches of Electronic Databases

Description of Methods Used to Collect/Select the Evidence

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.

Number of Source Documents

Not stated

Methods Used to Assess the Quality and Strength of the Evidence

Weighting According to a Rating Scheme (Scheme Given)

Rating Scheme for the Strength of the Evidence

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

Methods Used to Analyze the Evidence

Review of Published Meta-Analyses

Systematic Review

Description of the Methods Used to Analyze the Evidence

Not stated

Methods Used to Formulate the Recommendations

Expert Consensus

Description of Methods Used to Formulate the Recommendations

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.

Cost Analysis

A formal cost analysis was not performed and published cost analyses were not reviewed.

Method of Guideline Validation

Peer Review

Description of Method of Guideline Validation

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.

References 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 External Web Site Policy

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 External Web Site Policy

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 External Web Site Policy

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 External Web Site Policy

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 External Web Site Policy

Type of Evidence Supporting the Recommendations

The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).

Potential Benefits

Improved patient and caregiver adaption and coping with serious illness and hospitalization

Potential Harms

Not stated

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.

Description of Implementation Strategy

An implementation strategy was not provided.

Implementation Tools

Audit Criteria/Indicators

Resources

For information about availability, see the Availability of Companion Documents and Patient Resources fields below.

IOM Care Need

Getting Better

Living with Illness

IOM Domain

Effectiveness

Patient-centeredness

Bibliographic Source(s)

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]

Adaptation

Not applicable: The guideline was not adapted from another source.

Date Released

2012 Nov 28

Guideline Developer(s)

Cincinnati Children's Hospital Medical Center - Hospital/Medical Center

Source(s) of Funding

Cincinnati Children's Hospital Medical Center

Guideline Committee

Not stated

Composition of Group That Authored the Guideline

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

Financial Disclosures/Conflicts of Interest

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.

Guideline Status

This is the current release of the guideline.

Guideline Availability

Electronic copies: Available from the Cincinnati Children's Hospital Medical Center External Web Site Policy.

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.

Availability of Companion Documents

The following are available:

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 External Web Site Policy.

Patient Resources

None available

NGC Status

This NGC summary was completed by ECRI Institute on January 28, 2013.

Copyright Statement

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.

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