A theory-based intervention and the mental wellbeing of depressed mothers of children with cancer

Abstract Background The fear, uncertainty, emotional exhaustion, and grief associated with caregiving of children with cancer can trigger maternal depression, which may disrupt family routines, caregiving abilities, and relationships among family members. Methods A two-arm, single blinded quasi-experimental study design was conducted among mothers who scored ≥ 5 from the PHQ-9. Screening of eligible respondents were based on the list of mothers and child dyad registered at the outpatient and daycare paediatric oncology treatment centres in Klang Valley, Peninsular Malaysia. The ADDIE model was utilized to guide for the systematic development of the module according to the constructs of the social cognitive theory (personal, behaviour and environment). Outcomes were measured at baseline, as well as immediately and 2-month post intervention. Generalised Equation E (GEE) was used in this study to determine the effectiveness of the theory-based health education intervention on knowledge, self-efficacy, stress, and coping skills. Results From 305 potential mothers, only 92 consented and eligible for the study, with 50 were allocated in the intervention and 42 in the control groups. GEE analysis showed that the SCODESS intervention had significant effects on cancer-related knowledge scores (immediately post-intervention: β = 0.66, 95%CI: 0.21, 9.20, p = 0.002, and 2-month follow-up: β = 1.18, 95%CI: 0.65, 1.70, p < 0.001) and problem-focused coping skills (immediately post-intervention: β = 2.50, 95% CI 0.42, 4.58, p-value=0.018, at 2-month follow-up: β = 2.42, 95% CI 0.13, 4.72, p-value=0.038) scores. Conclusions The intervention significantly increased the cancer-related knowledge and problem-focused coping skills scores. As a potential preventive strategy for depression, the content of the intervention should be revisited to also improve the caretaker self-efficacy, stress and depression. Future research could examine the cost-effectiveness of these approaches in real world settings. Key messages • Mental health is an important public health concern especially among women and caretakers. • Mental illness is highly preventable and treatable with effective intervention.