Objective: The period after successfully coming off treatment (SCOT) following a childhood cancer diagnosis is known to be a vulnerable time for parents in which increased levels of distress can...Show moreObjective: The period after successfully coming off treatment (SCOT) following a childhood cancer diagnosis is known to be a vulnerable time for parents in which increased levels of distress can play a significant role. It is important to know more about the distress experienced by parents during this period to determine whether an intervention should be used to help parents return to ‘normal life’. The aim of this study was therefore to gain better understanding of parental distress and factors related to their distress during the first year after their child has successfully completed treatment. Methods: A sample of 283 parents of children who had successfully completed cancer treatment in the previous year were included in this cross-sectional study. These parents, who were part of the SCOT group, were invited to complete the Distress Thermometer for Parents (DT-P) within one year after treatment completion. The DT-P consists of a thermometer score to measure experienced distress and problem domains (practical, social, emotional, physical, cognitive, and parenting). Parents in the SCOT group were compared with parents in the general population (NORM group) to see if their distress levels were higher. In addition, the association between distress and the problem domains and child- or parent-related factors (time since the end of treatment, cancer type, child’s age, parental disease, and perceived support) was examined. Results: Parents (73.9% mothers) in the SCOT group experienced higher levels of distress in the first year after SCOT compared to the general population (fathers SCOT: M=3.5, SD=2.6 vs. fathers NORM: M=2.8, SD=2.5; p=.032; mothers SCOT: M=4.1, SD=2.7 vs. mothers NORM: M=3.5, SD=2.7; p=.001). Emotional (p<.001), practical (p=.016), and physical (p=.005) problems were predictors of higher distress levels. Parents’ perceived support from their environment contributed also to their level of distress (p<.001). Conclusions: Parents of children who have successfully completed cancer treatment experience increased levels of distress in the first year after treatment compared to parents in the general population. There may be value in developing an intervention to ease this transition that specifically addresses their emotional well-being and highlights the importance of their social network during this vulnerable period.Show less
Objective: Parental factors play an important role in the development and maintenance of childhood anxiety. However, studies show mixed results when exploring the relationships between parental...Show moreObjective: Parental factors play an important role in the development and maintenance of childhood anxiety. However, studies show mixed results when exploring the relationships between parental anxiety, parental coping and the anxiety of the child. This study will further explore these relationships by looking at children with specific phobias and their parents. We will investigate if there is a relation between child anxiety and parental anxiety, if parental anxiety predicts the treatment outcome, if there is a relation between parental anxiety and parental coping, and if parental anxiety is a mediator between the parental coping style positive reinforcement and the treatment outcome. Methods: The study employed a longitudinal one-group pretest-posttest design with a correlational and experimental approach. Participants were 58 children between the ages of 7 and 14 years with a specific phobia. The treatment consisted of a 3-hour exposure session. The Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions (ADIS-IV-C/P) was used to assess both the severity of the anxiety of the child and the treatment outcome. Parental anxiety was assessed using the Anxiety subscale of the Depression Anxiety Stress Scale – 21 (DASS-21). Parental coping styles were assessed using an adapted version of the Child Development Questionnaire (CDQ). The formulated hypotheses were analysed using spearman rank correlation tests, a generalized linear model and a mediation analysis. Results: There was no correlation between parental anxiety and the anxiety of the child at baseline, nor did parental anxiety predict the treatment outcome. Moreover, there was no correlation between parental anxiety and parental coping. Finally, parental anxiety did not mediate between the parental coping style positive reinforcement and the treatment outcome. Conclusions: No relationships were found between the anxiety of children with a specific phobia, parental anxiety and parental coping. These unexpected results and limitations are discussed. Further research is important to examine the potential ways in which parents could contribute to alleviating the anxiety of children with specific phobias.Show less
Research master thesis | Psychology (research) (MSc)
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Objective: Childhood anxiety disorders are a widespread concern that may impede children’s development. Cognitive Behaviour Therapy (CBT) with exposure is considered an effective treatment for...Show moreObjective: Childhood anxiety disorders are a widespread concern that may impede children’s development. Cognitive Behaviour Therapy (CBT) with exposure is considered an effective treatment for childhood anxiety. After treatment, home practice helps children to develop skills that they learned during CBT. However, home practice is often challenging for children. Mobile health (mHealth) apps have the potential to facilitate home practice. We aimed to describe the development of the KiBA (Kids Beat Anxiety) app and test its usability. Method: In Study 1 (development phase), we included therapists (n = 5) and children (n = 8, aged 7- 14) to review app mock-ups during five meetings. IT-specialists incorporated the feedback multiple times. Next, two beta-tester groups tested the app and rated its usability. The first group tested the app for one hour at school (n = 14, mean age = 9.50), and the second group tested the app for one week at home (n = 8, mean age = 10.55). In Study 2 (clinical sample), children with a specific phobia (n = 8, Mage = 12.10) used the app for four weeks at home following CBT, and children and parents rated its usability. Results: Feedback led to multiple improvements (e.g., game elements, layout, colors, instructions). Usability ratings were both high in the beta-tester groups in the development phase (8.4/10 and 8.1/10) and the clinical sample (8.6/10 children and 8.1/10 parents). Children indicated they found the app easy, fun, and user-friendly. Conclusions: This study underlines the value of including end-users in the development of mHealth apps. The KiBA app (1) offers tools for children and their parents to practice exposure at home, and (2) helps therapists to monitor children’s progress.Show less
