A systematic review and meta-analysis of the effectiveness of interventions to improve psychological wellbeing in the parents of children with cerebral palsy

Background: Caregivers of children with cerebral palsy (CP) face unique demands and challenges, with potential negative impact on psychological wellbeing and consequences for both caregiver and child. Timely support could improve parental wellbeing. Aim: To evaluate the effectiveness of interventions aimed at improving the psychological wellbeing of caregivers of children with CP. Methods and procedures: Systematic review and meta-analysis of randomised controlled trials of interventions to improve the psychological well-being of caregivers of children with cerebral palsy. Databases (including MEDLINE, EMBASE, PsycINFO, Cochrane) were searched for relevant English language publications between January 1990 and December 2017. Risk of bias was assessed including randomization, allocation concealment, incomplete outcome data and selective outcome reporting. Outcome and results: We included 13 studies (1293 participants, 1/3 with CP). Six studies investigated a positive parenting intervention; the other seven studies covered a range of other interventions. Meta-analysis of 7 studies (662 participants) showed that interventions significantly improved parental wellbeing (standardised mean difference -0.61, 95% CI -0.92 to -0.30, z = 3.84, p = 0.0001). Conclusions and implications: Limitations include small sample sizes and heterogeneity in study design; however, our results indicate that interventions can improve the wellbeing of parents of children with CP and should be made available.