The Role of Compassion and Mindfulness in Building Parental Resilience When Caring for Children With Chronic Conditions: A Conceptual Model

How do care partners overcome the challenges associated with falls of community-dwelling older people with dementia? A qualitative study

BACKGROUND AND OBJECTIVES

Previous studies have found that falls among community-dwelling older people with dementia negatively impact the health and well-being of their relative/friend care partners. Limited studies have explored the challenges care partners experience because of older people's falls (including fall incidents and fall risks). We sought to investigate care partners' experiences of these challenges and how care partners responded.

METHODS

We conducted an inductive thematic analysis of 48 dementia care partner interviews (age range: 33-86, mean: 61, 70.8% women; 58.3% adult children; 29.2% spouse; 62.5% completed college; 25% people of color), conducted after a health crisis of older people with dementia from three local university-affiliated hospitals in the United States.

FINDINGS

Care partners reported that falls in older people with dementia can intensify overall care demands and lead to self-sacrificing behaviors, dissatisfaction with healthcare providers, conflicts with care recipients, and intense emotions. Care partners described several adaptations to mitigate these impacts, including practicing acceptance, approaching falls as an opportunity for learning, facilitating collaborations within formal/informal care networks, collaborating with older people with dementia to balance autonomy and safety, and modifying the physical environment.

DISCUSSIONS AND IMPLICATIONS

Falls among older people with dementia are a significant stressor and an important activation stimulus for their care partners. Our findings suggest that care partners are "second clients" and "competent collaborators." As they provide important insights about fall prevention, care partners should be engaged to co-design new multi-level interventions to facilitate collaborations among care networks, older people with dementia, and service providers.

"It makes me a better person": The unique experiences of parenting multiple children who experience neurodevelopmental disability

BACKGROUND

Much research has explored how raising a child with a neurodevelopmental disability influences parents' well-being. However, little research has focused on the unique experiences of parenting multiple children with neurodevelopmental disabilities. We explored the unique experiences of parenting multiple children with neurodevelopmental disabilities with a focus on mothers' well-being and social participation.

METHODS

Ten mothers who parent multiple children with neurodevelopmental disabilities participated in semi-structured interviews. Interviews were analyzed using a reflexive thematic approach.

RESULTS

Three themes were identified: 'Knowledge is power' described positive influences of enhanced disability knowledge and advocacy with each child who experienced disability. 'Shifts in wellbeing' acknowledged these mothers' exhaustion, decreased time for self-care, and invisible work, yet also increased feelings of empowerment, purpose and empathy for others. '(Dis)Connection and engagement with others' reflected struggles of balancing responsibilities, social and community participation, and experiences with isolation. Yet, mothers' also experienced enhanced disability community and family connections, and a sense of meaning and purpose.

CONCLUSIONS AND IMPLICATIONS

Findings highlighted challenges, and many rewarding and unique experiences of parenting multiple children with neurodevelopmental disabilities. Health, education and social service practitioners are encouraged to acknowledge parent's challenges, but also celebrate and draw on families' strengths and knowledge.

Who is supporting the parents during their child's cancer treatment? A qualitative study through the lens of compassion

PURPOSE

Parents of children/adolescents with cancer are placed in a state of severe suffering due to serious concerns, fears, and radical daily life changes. Human support is an important source of support for successful coping. This study explored fundamental aspects of parents' daily, social, and personal life during their child's treatment to deepen our understanding of 'who' plays a significant role in supporting parents, and how, and to what extent this support is provided.

METHODS

This qualitative study was undertaken in a compassion paradigm, designed and guided by Heidegger's and Gadamer's philosophy and compassionate methods. Data were generated through ethnographic observations (144 h), focus group interviews (n = 2), and individual/couple interviews (n = 16) at two Danish hospitals. Inductive content analysis was used to analyse data.

RESULTS

Overall, support from peers, health professionals, and social networks constituted significant sources of support. Especially peers and health professionals had a continuous support role, which was fundamental for establishing interpersonal closeness and relieving suffering. Sharing responsibilities between parents and among social networks seemed to ease the emotional and practical burden. However, to ensure effectiveness, social networks must be available, outreach, and responsive to needs. Moreover, parents disclosed little self-awareness and resources and options for self-care due to a combination of lack of awareness, time, and space in the hospitals.

CONCLUSION

Safeguarding interpersonal and interparental understanding and closeness in parental care is essential. One way is building resilience and a broader human-to-human-based safety net around the family, including social networks and professional psychosocial support, advantageously using compassion.

Quality of life in caregivers of a child with a developmental and epileptic encephalopathy

AIM

To explore the relationship between social care-related quality of life (SCrQoL) for caregivers of a child with a developmental and epileptic encephalopathy (DEE; such as SCN2A and Dravet syndrome) and health literacy, illness perceptions, and caregiver activation.

METHOD

As part of a larger pre-post pilot study of an information linker service, caregivers completed a baseline questionnaire which included demographics and measures to assess SCrQoL, health literacy, illness perceptions, and caregiver activation. We used Spearman's Rho to determine relationships between variables.

RESULTS

Seventy-two caregivers completed the questionnaire. Total SCrQoL varied widely, ranging from an 'ideal state' to 'high needs state'. Caregivers most frequently reported high needs regarding doing activities they enjoy and looking after themselves. Total SCrQoL was correlated with cognitive (r[70] = -0.414, p < 0.000) and emotional representations of illness (r[70] = -0.503, p < 0.000), but not coherence (r = -0.075, p = 0.529). Total SCrQoL was not correlated with health literacy (r[70] = 0.125, p = 0.295) or caregiver activation (r[70] = 0.181, p = 0.127).

INTERPRETATION

Future research should explore whether interventions that help caregivers cognitively reframe the negative experiences of having a child with a DEE, and support them to partake in activities they enjoy, boost their SCrQoL.

WHAT THIS PAPER ADDS

Caregiver social care-related quality of life (SCrQoL) varied widely, from 'ideal state' to 'high needs state'. Most common high needs were doing enjoyable activities and self-care. Caregivers with higher SCrQoL may perceive their child's illness as less threatening. SCrQoL does not appear to be related to caregiver activation in this sample.

The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study

PURPOSE

This study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants.

DESIGN AND METHODS

A cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively.

RESULTS

The mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively. Mental resilience was a significant mediator explaining the effect of stress on active coping (β = -0.294; 95% bias-corrected bootstrap CI: -0.358 to -0.164).

CONCLUSIONS

Attention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style.

PRACTICE IMPLICATIONS

This study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.

Early Intervention, Regular Education, and Family: Reciprocal Influences on Communication and Language Disorders

Families are the primary caregivers and the main source of support for their children. Family resilience involves coping and adapting to stressful situations. This study explored the impact of previous treatment experience on parental resilience, in families, as well as the relationship between family history of communication and language disorders and parental stress. These variables were assessed through the Resilience Scale and the Parental Stress Index in parents of 220 children aged 3 to 6 years attending mainstream schools and early intervention (EI) centers in Caceres (Spain). The results revealed significant differences in resilience between parents who had received previous treatments and those who had not (p = 0.11). Furthermore, a significant association was found between having no family history of communication and language disorders and the Dysfunctional Parent-Child Interaction subscale from the Parental Stress Index (U = -2.079, p = 0.038). These findings highlight the relevance of previous experience in EI to build family resilience as resilient parents are more likely to be actively involved in their children's education and create a supportive environment. Thus, promoting resilience in educational settings may have positive effects on children's and families' quality of life during the EI process.

Roles of Parental Psychological Flexibility, Self-Compassion, and Self-Efficacy in Affecting Mental Health and Quality of Life in Parents of Children with Eczema

Parents of young children with eczema often experience adverse mental health consequences, including depression, anxiety, stress, and a reduced health-related quality of life (HRQoL), due to the unpredictable nature of flare-ups and exacerbations. This study investigated the roles of psychological flexibility, self-compassion, and self-efficacy in fostering parental mental health outcomes and HRQoL while caring for children diagnosed with eczema. Baseline data from an ongoing clinical trial examining the effects of a family acceptance-and-commitment-therapy-based eczema management program (FACT-EMP) on parent-child dyads affected by eczema (N = 110 dyads, 75.5% mothers; 66.4% boys) were analyzed using adjusted hierarchical regression analyses. The findings indicate that psychological inflexibility was significantly associated with symptoms of anxiety, depression, stress, and HRQoL. Self-compassion was significantly linked to all assessed mental health outcomes, whereas self-efficacy showed a significant association only with symptoms of depression. These results underscore the significance of promoting parental psychological flexibility and self-compassion through acceptance and commitment therapy and compassion-based approaches to enhance mental health and quality of life while managing children's eczema.

Validation and expansion of a behavioral framework for dementia care partner resilience (CP-R)

BACKGROUND AND OBJECTIVES

Resilience - the ability to bounce back after a stressor - is a core component of successful family caregiving for people living with dementia. In this manuscript, we describe the preliminary empirical validation of a new behavioral framework developed from existing literature for assessing care partner resilience, CP-R, and propose its potential value for future research and clinical care.

METHODS

We selected 27 dementia care partners who reported significant challenges prompted by a recent health crisis of their care recipient from three local university-affiliated hospitals in the United States. We conducted semi-structured interviews to elicit care partners' accounts of what they did to address those challenges that helped them recover during and after the crisis. Interviews were transcribed verbatim and analyzed using abductive thematic analysis.

FINDINGS

When persons with dementia experienced health crises, care partners described various challenges in managing new and often complex health and care needs, navigating informal and formal care systems, balancing care responsibilities with other needs, and managing difficult emotions. We identified five resilience-related behavioral domains, including problem-response (problem-solving, -distancing, -accepting, and -observing), help-related (help-seeking, -receiving, and -disengaging), self-growth (self-care activities, spiritual-related activities, and developing and maintaining meaningful relationships), compassion-related (self-sacrifice and relational compassion behaviors), and learning-related (learning from others and reflecting).

DISCUSSIONS AND IMPLICATIONS

Findings support and expand the multidimensional CP-R behavior framework for understanding dementia care partner resilience. CP-R could guide the systematic measurement of dementia care partners' resilience-related behaviors, support individual tailoring of behavioral care plans, and inform the development of resilience-enhancing interventions.

The psychosocial impact of childhood dementia on children and their parents: a systematic review

BACKGROUND

Childhood dementias are a group of rare and ultra-rare paediatric conditions clinically characterised by enduring global decline in central nervous system function, associated with a progressive loss of developmentally acquired skills, quality of life and shortened life expectancy. Traditional research, service development and advocacy efforts have been fragmented due to a focus on individual disorders, or groups classified by specific mechanisms or molecular pathogenesis. There are significant knowledge and clinician skill gaps regarding the shared psychosocial impacts of childhood dementia conditions. This systematic review integrates the existing international evidence of the collective psychosocial experiences of parents of children living with dementia.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched four databases to identify original, peer-reviewed research reporting on the psychosocial impacts of childhood dementia, from the parent perspective. We synthesised the data into three thematic categories: parents' healthcare experiences, psychosocial impacts, and information and support needs.

RESULTS

Nineteen articles met review criteria, representing 1856 parents. Parents highlighted extensive difficulties connecting with an engaged clinical team and navigating their child's rare, life-limiting, and progressive condition. Psychosocial challenges were manifold and encompassed physical, economic, social, emotional and psychological implications. Access to coordinated healthcare and community-based psychosocial supports was associated with improved parent coping, psychological resilience and reduced psychological isolation. Analysis identified a critical need to prioritize access to integrated family-centred psychosocial supports throughout distinct stages of their child's condition trajectory.

CONCLUSION

This review will encourage and guide the development of evidence-based and integrated psychosocial resources to optimise quality of life outcomes for of children with dementia and their families.

Feeling stretched: Parents' narratives about challenges to resilience when their child has a tracheostomy

This study aimed to examine how parents develop personal resilience when facing the challenges of caring for a child with tracheostomy. This study employed a longitudinal qualitative design. Unstructured narrative interviews with 12 parents (from nine families) whose child had a new tracheostomy were undertaken at three time points over 12 months. Data were analysed using a socio-narratology method. Findings reveal the journey parents experienced, how their feelings changed and the processes involved in developing resilience over the first 12 months of their child having a tracheostomy. Stories told by parents early in their journey revealed emotional upheaval, negative emotions, stress and shock. Due to medical need, parents had little or no choice for their child to have a tracheostomy. Once their child's life was out of danger, parents started to reframe their experiences and beliefs. Resilience played a major part in how parents perceived and faced their situation, allowing them to deal with what came their way and to move forward with their lives. Different aspects of resilience such as self-awareness, grit, gratitude, internal locus of control and reframing came to the fore at different time points. Parents talked feeling stretched by the challenges they faced and how they reframed their perspectives about their child's tracheostomy. Parents' resilience and reframing is discussed in relation to the ABC-X model. This study identifies a theoretical model that explains this process of change, this results in transferable knowledge, useful for understanding and explaining the experience of other parents and families.

Mindful parenting-A thematic exploration of narratives from Indian mothers

Introduction

With the global crisis of COVID-19 continuing, Indian mothers have not received adequate attention with respect to their challenges and mothering experiences. The current study explored mindful parenting practices in a cohort of Indian mothers of children aged 10 years and below that emerged in response to the challenges posed by COVID-19.

Methods

In-depth virtual interviews were conducted with 31 urban Indian mothers to explore their lived experiences of mothering during the global crisis and their engagements with mindful parenting practices. The data were thematically analyzed.

Results and Discussion

The study identified two overarching themes and nine subthemes. The first theme, pandemic-induced stress, included the sub-themes of increased workload, poor support system, lack of time for self, and emotional and physical distress. The second theme of mindful parenting included the sub-themes of awareness as a mother and around the child, acceptance toward self and the child, empathic understanding of self and the child, active engagement with the child, and emotional regulation. Increased workload on all fronts coupled with poor support and a lack of time for self-contributed to exacerbated emotional and physical stress in mothers. They addressed these concerns posed by their lived experiences by engaging in mindful parenting processes in their mothering practices. Mindfulness-based cognitive therapy, mindfulness-based stress reduction, and mindfulness-based parenting techniques could be explored as possible interventions for mothers to alleviate their distress while drawing attention to larger structural changes and policy-level interventions addressing social issues such as gender inequality and childcare concerns.

Are mindfulness groups more mindful face to face or online? A comparison of delivering a mindfulness based well-being group for parents of children with a chronic health condition

INTRODUCTION AND AIMS

Mindfulness has been shown to be an effective group intervention for adults and children living with a range of medical conditions. Recently, research has also explored the impact of mindfulness interventions offered to parents of children with health conditions. Few studies have examined whether the mode of delivery (face-to-face vs online) has an impact on outcomes.

METHODS

Four mindfulness based wellbeing courses for parents (MBWP) of children with a chronic medical condition were run (two face to face and two online). All parents (N=37) completed the WHO Well-being Questionnaire and Neff Self-Compassion Scale Questionnaire-Short Form at the beginning and end of each course. Parents' experience of the course was also explored using a semi-structured interview 6 weeks after completing the course, with their responses analysed using Thematic analysis.

RESULTS

The groups had a statistically significant positive impact on both parent well-being and self-compassion and were equally effective face-to-face or online. All parents reported incorporating informal mindfulness practices into their day-to-day lives 6 weeks post-course The qualitative analysis highlighted improvements in present moment focus, kindness to self, and family relationships.

DISCUSSION AND CONCLUSION

Parents valued connecting with other parents of young people with both similar and different medical conditions, within both face-to-face and online groups, increasing the accessibility of MBWP.

Caregiver perspectives of dialysis initiation for children with kidney disease: a qualitative study

BACKGROUND

To better support family-centered care surrounding dialysis initiation, greater understanding of caregiver experience is necessary.

METHODS

Using thematic analysis, we conducted a secondary analysis of semi-structured interview data from a qualitative study of caregivers of children receiving dialysis recruited from 3 pediatric centers. Prominent themes in caregiver experience of caring for a child initiating dialysis were identified.

RESULTS

Thirty-five caregivers participated. Three major themes emerged from qualitative analysis: (1) parenting disrupted - caregivers experienced an acute disruption in their parenting role due to the unexpected, emergent circumstances and vast information accompanying their child's diagnosis; (2) redefining parenting - caregivers sought to reestablish their innate parental role and foster their evolving medical provider role through reassurance that their child could survive, communication with the medical team, and engaging in care plan development; and (3) leveraging dual identities - to positively impact their child's experience and enable flourishing, caregivers leveraged their established caregiver role and newly realized medical provider role through voicing their perspectives, watching over their child's care, and preparing for future changes in their child's health. If caregivers' evolution was not nurtured and enabled, acute fluctuations in their child's care could contribute to future disruption and need to restore their parental role. However, if caregiver development was fostered, caregivers acquired increased ability to prepare for vacillations in their child's care.

CONCLUSIONS

Improving delivery of family-centered care and support of caregivers at dialysis initiation will require directed efforts by nephrology care teams to foster caregiver evolution and resilience and respond to the family's changing experience of kidney disease. A higher resolution version of the Graphical abstract is available as Supplementary information.

Brief report of protective factors associated with family and parental well-being during the COVID-19 pandemic in an outpatient child and adolescent psychiatric clinic

Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family (e.g., co-parenting) and from external sources (e.g., mental health services) were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support.

Patient and carer experience of living with a pressure injury: A meta-synthesis of qualitative studies

INTRODUCTION

Pressure injuries are a significant cause of harm, contributing to increased mortality and financial burden on the healthcare system. Significant research on pressure injury risk assessment, prevention and treatment exists, but limited research exploring the patient and carer experience of living with pressure injury.

AIMS

The aim of this meta-synthesis was to describe the patient and carer experience of living with a pressure injury.

DESIGN

Meta-synthesis.

METHODS

A prospective review protocol was registered, and systematic search conducted across five electronic databases. The PRISMA 2020 checklist for reporting systematic reviews was used. Two reviewers independently undertook screening and review of articles, using the CASP checklist for evaluating qualitative research. A meta-synthesis using thematic content analysis was undertaken.

RESULTS

Twelve studies met the inclusion criteria. Meta-synthesis led to the construction of three primary themes: loss of autonomy and independence, psychological effects, and adjustment. Within these primary themes, sub-themes of dependence, social isolation and social avoidance behaviours, feelings and emotions, loss, managing, physical consequences, service provision, and functional challenges, were identified.

CONCLUSION

The psychology and mindset of those involved, and support to navigate the challenges that arise are two unique and clinically relevant categorisations to guide provision of pressure injury care. Adaptation to a pressure injury is multi-faceted and contextual, challenges to adaptation create additional psychological burden. Interventions encompassing all facets of the experience are necessary. Current research into experiences is limited, and further research to support interventions is necessary.

Self-Compassion and Rumination Type Mediate the Relation between Mindfulness and Parental Burnout

The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through mindfulness practice: trait mindfulness, self-compassion, and concrete vs. abstract ruminations. A total of 459 parents (M_age = 40; 98.7% female) completed self-reported questionnaires at two-time points to assess the predictive role of mindfulness on parental burnout, self-compassion and rumination type, and the mediating role of self-compassion and rumination type in the relation between mindfulness and parental burnout. Results showed that trait mindfulness, self-compassion, and rumination type at Time 1 predicted levels of parental burnout at Time 2. Self-compassion (indirect effects: b = − 22, 95% CI = [−38, −05], p < 0.01), concrete ruminations (indirect effects: b = −20, 95% CI = [−32, −09], p < 0.001), and abstract ruminations (indirect effects: b = −0.54, 95% CI = [−71, −37], p < 0.001) partially mediated the relation between trait-mindfulness and parental burnout. These findings showed that trait mindfulness, self-compassion, and concrete (vs. abstract) ruminations may help prevent parental burnout in the context of the COVID-19 pandemic. These results contribute to the field of research on parental burnout prevention and will allow for the development of effective approaches to mental health promotion in parents.

Effectiveness of self-compassion training on hopelessness and resilience in parents of children with cancer

OBJECTIVES

the psychological state of parents, who are considered the primary caregivers of a sick child, can affect the child's behavior and emotions. This study analyzed the effectiveness of self-compassion training on hopelessness and resilience in the parents of children with cancer.

METHODS

this was an experimental study with a pre-test and post-test design and a control group. The statistical population included all parents of children with cancer hospitalized in Amir Kabir Hospital of Arak in 2020. The research sample consisted of 30 parents of children with cancer selected through convenience sampling. The participants were equally divided into experimental (n = 15) and control (n = 15) groups at random. The research instruments were the Connor-Davidson Resilience Scale (CD-RISC) and the Beck Hopelessness Scale (BHS). The experimental group underwent eight 90 min sessions of self-compassion training on a weekly basis. Finally, the multivariate analysis of covariance (MANCOVA) was employed for data analysis.

RESULTS

the mean (±SD) of the post-test scores of hopelessness and resilience were reported 10.20 (±4.95) and 43.33 (±4.27), respectively, in the experimental group, whereas they were reported 13.78 (±4.94) and 38.73 (±4.07), respectively, in the control group. According to the results, self-compassion training had significant effects on the resilience and hopelessness of the parents of children with cancer (p < 0.01). Self-compassion training had a positive, significant effect on their resilience. It was also efficient in decreasing their hopelessness.

CONCLUSIONS

self-compassion training improved resilience and mitigated hopelessness in the parents of children with cancer.

The Role of Parent/Caregiver with Children Affected by Rare Diseases: Navigating between Love and Fear

In this paper, we propose a vision of the role of parent/caregiver with children affected by a rare disease. This vision is rooted in data obtained from our own research; however, our analysis and interpretation of this data have been subsequently checked against existing theoretical models. The research aims to explore how parents who look after children with a rare disease experience their role as caregivers and how they assimilate their role identity in this task. Semi-structured interviews were performed with parents of 10 children, and a qualitative data analysis was conducted using grounded theory. We have identified ten main categories using a grounded theory approach: stress, disorientation, insecurity, isolation, faith, trust, attention, communication with professionals, private proactivity and public proactivity. Our results also show that when parents perceive a greater burden due to looking after a child with a rare disease, the result is a change in the usual parental role. In our contribution, we offer a general outline of how parents build a role identity centred on caring for a child with a rare disease. We posit that this role identity is the outcome of the parents’ success or failure in gradually overcoming fear through love. We have conceptualized this process as navigating between love and fear.

Acceptance and Commitment Therapy for psychological and behavioural changes among parents of children with chronic health conditions: A systematic review

AIMS

To systematically identify the application of Acceptance and Commitment Therapy among parents of children with chronic health conditions and determine its effectiveness in parental psychological flexibility, psychological distress and parenting behaviour.

DESIGN

Systematic review.

DATA SOURCES

Nine databases (i.e. MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, PsychINFO, Web of Science, China National Knowledge Infrastructure and WanFang Data) were systematically searched from inception to October 2019.

REVIEW METHODS

Quality of studies was appraised by using the Joanna Briggs Institute critical appraisal checklist. Findings were synthesized narratively. This work was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

RESULTS

Eight studies involving 485 parents were included. Results indicated that Acceptance and Commitment Therapy significantly improved parental psychological flexibility and reduced psychological distress compared with usual care and waitlist, but was not significantly different from active treatments. Limited studies have provided very preliminary evidence that Acceptance and Commitment Therapy can significantly improve dysfunctional parenting behaviour than usual care and waitlist. High attrition rate at follow-up made the overall confidence of maintained effect relatively low.

CONCLUSION

This review provides preliminary evidence that Acceptance and Commitment Therapy is beneficial for improving psychological flexibility, psychological distress and parenting behaviour among parents of children with chronic health conditions. Future studies with rigorous designs and large sample sizes are warranted to verify the evidence and explore its long-term efficacy.

IMPACT

Acceptance and Commitment Therapy has been increasingly applied to parents of children with chronic health conditions. This review provides positive evidence of its effects on psychological and behavioural outcomes among these parents. This work will help healthcare professionals and researchers with their practice and further research.