A Mobile Instant Messaging–Delivered Psychoeducational Intervention for Cancer Caregivers: A Randomized Clinical Trial
Mené en Chine sur 160 aidants d'adolescents ou jeunes adultes atteints d'un cancer, cet essai randomisé évalue l'intérêt d'une intervention psycho-pédagogique dispensée par messagerie instantanée pour diminuer leurs symptômes d'anxiété et de dépression et améliorer leur qualité de vie
Importance : Psychoeducational interventions (PEIs), which provide both information and emotional and psychosocial support, may address the unmet needs of the caregivers of adolescent and young adult patients with cancer. Objective : To explore the effects of an instant messaging–delivered PEI on anxiety, depression, quality of life (QOL), and coping and determine whether the intervention reduces caregivers’ unmet needs. Design, Setting, and Participants : This randomized clinical trial using an intention-to-treat protocol was conducted from April 1 to September 14, 2022, in a tertiary cancer hospital in China and included caregivers of patients diagnosed with cancer at age 15 to 39 years recruited using convenience sampling. Intervention : Caregivers were allocated 1:1 using a randomized block scheme to the intervention or control group. The intervention group received a 5-week PEI and usual care, whereas the control group received only usual care. The PEI was delivered through articles and calls through an instant messaging application. Main Outcomes and Measures : The primary outcomes were changes in the levels of caregivers’ anxiety and depression, measured using the 7-Item Generalized Anxiety Disorder Scale and the Patient Health Questionnaire 9, respectively. The secondary outcomes were changes in the levels of caregivers’ QOL, coping, and unmet needs. Results : Of the 160 participants, 92 (57.5%) were male; mean (SD) age was 40.27 (8.33) years. Compared with the control group, the intervention group had significantly greater reduction in severity of anxiety (B =
−
3.231; 95% CI,
−
4.746 to
−
1.716; P < .001) and depression (B =
−
3.253; 95% CI,
−
5.052 to
−
1.454; P < .001), smaller reduction in QOL (B = 13.574; 95% CI, 0.488-26.661; P = .04), and greater reduction in unmet needs (B =
−
12.136; 95% CI,
−
18.307 to
−
5.965; P < .001) after the intervention. Twelve weeks after baseline, the intervention group demonstrated a significantly greater reduction only in severity of anxiety (B =
−
1.890; 95% CI,
−
3.382 to
−
0.397; P = .01). Conclusions and Relevance : In this randomized clinical trial of a mobile instant messaging–delivered PEI, caregivers’ unmet needs, anxiety, and depression decreased significantly and QOL declined at a significantly slower rate immediately after the intervention in the intervention group compared with the control group. A sustained effect on anxiety was observed 12 weeks after baseline. Trial Registration : Chinese Clinical Trial Registry identifier: ChiCTR2200055951