A pilot study of disease related education and psychotherapeutic support for unresolved grief in parents of children with CF

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作者
André Schultz
Andrea Barrett
Elizabeth Balding
Wesley Billingham
Cindy Branch-Smith
Zubin Grover
Gisele Yikilmaz
Crystal Bourke
Julie Depiazzi
Nicole Sander
Juliet Foster
Matthew Cooper
Florian Zepf
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[1] University of Western Australia,Wal
[2] University of Western Australia,Yan Respiratory Research Centre, Telethon Kids Institute
[3] Perth Children’s Hospital,Division of Paediatrics and Child Health, Faculty of Medicine
[4] Woolcock Institute of Medical Research,Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital
[5] Friedrich Schiller University Jena,Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Division of Psychiatry & Clinical Neurosciences, School of Medicine, Faculty of Health and Medical Sciences
[6] University of Western Australia,undefined
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Diagnosis of chronic disease in a child can result in unresolved grief (UG) in parents. This study aimed to evaluate the efficacy of psychological insight-oriented therapy (IOT) as a treatment for UG compared to disease related education in parents of children with cystic fibrosis (CF). Sequence of delivery, first IOT then disease related education (or vice versa) was also examined, to let all participants experience both interventions. Parents were screened for UG. Parents with UG were randomised to either five 1-h sessions of IOT or five 1-h sessions of education. Measures were assessed pre-intervention, after the first intervention period (primary efficacy assessment), and after the second intervention period (swapping intervention). Forty-seven parents were screened of which 46.8% (22/47) had UG. Median duration of UG was 5 years (range: 6 months–14 years). Anxiety (50% vs. 20%, p = 0.03) and stress (59% vs. 28%, p = 0.03) were significantly more prevalent in parents with UG. There was no difference between arms in the odds of UG resolving either following the first intervention period (OR 0.88; 95% CI 0.5, 1.5) or the second intervention period (OR 0.91; 95% CI 0.5, 1.6). While not statistically significant, adjusted mean values for seven of the eight mental health measures were lower in the IOT (first) arm compared to the ED (first) arm, following the first intervention period. UG is a significant burden for families affected by CF. Provision of disease related education and psychological support, regardless of sequence, can result in resolution of grief.
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