Integrating a problem-solving intervention with routine care to improve psychosocial functioning among mothers of children with sickle cell disease: A randomized controlled trial

Abstract

Objective To assess the feasibility of a problem-solving skills training intervention in improving psychological outcomes in mothers of infants with sickle cell disease (SCD). Design and methods This parallel randomized controlled trial recruited 64 babies with SCD, 6 to 12 months of age, and their mothers. Baseline measurements assessed mothers’ coping and problem-solving skills, depression, and parental stress before random assignment to intervention or control groups (n = 32 each). Problem-solving skills intervention was delivered through 6 monthly sessions, when babies attended for routine penicillin prophylaxis. All measurements were repeated for both groups at the end of the intervention period. Intention to treat analysis used repeated measures mixed models with the restricted estimation maximum likelihood approach. Results The problem-solving intervention had no significant effect on mothers’ problem-solving skills (adjusted treatment effect: -1.69 points (95% CI:-5.62 to 2.25)), coping behaviours (adjusted treatment effect: 0.65 points (95% CI:- -7.13 to 8.41)) or depressive symptoms (adjusted treatment effect: -0.41 (95% CI: -6.00 to 5.19)). It reduced mothers’ level of difficulty in managing stressful events by 9.5 points (95% CI (-16.86 to -2.16); effect size: 0.21 SD). In the subgroup of mothers at risk of depression (n = 31 at baseline), the intervention reduced depression scores with treatment effect of 10.4 points (95%CI: -18.83 to -1.88; effect size: 0.67 SD). Conclusion This problem-solving skills intervention study suggests feasibility and possible efficacy in improving some maternal outcomes. Further refinement and culturally appropriate adaptations of the intervention could lead to stronger effects.

Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis

“…After removal of duplicates ( n = 2,298), a total of 4,884 titles and abstracts were assessed for eligibility, 296 of which fulfilled the eligibility criteria. After inspection of full-texts, a total of 23 studies (Abhari et al, 2021; Asnani et al, 2021; Baumgartner et al, 2021; Chaharrahifard et al, 2021; Dayhimi et al, 2020; Gao et al, 2010, 2015; George et al, 2020; Guo et al, 2021; Koçak et al, 2021; Li et al, 2019; Mao et al, 2012; Ozcan & Eryilmaz, 2021; Özçoban et al, 2022; Rajeswari & SanjeevaReddy, 2020; Ramezani et al, 2017; Rong et al, 2021; Rotheram-Borus, Richter et al, 2014; Rotheram-Borus, Tomlinson et al, 2014; Sanfilippo et al, 2020; Sapkota et al, 2022; Tripathy et al, 2010; Vargas-Porras et al, 2021) from 28 publications (Supplemental Appendix D) with 24,442 participants were included in the systematic review. Of these, 22 provided data suitable for the meta-analysis (Figure 1 and Supplemental Appendix D, E).…”

“…Psychosocial interventions were provided by primary-level health care workers (e.g. midwives, nurses, obstetricians) in 16 studies (Abhari et al, 2021; Asnani et al, 2021; Chaharrahifard et al, 2021; Dayhimi et al, 2020; Gao et al, 2010, 2015; Guo et al, 2021; Koçak et al, 2021; Li et al, 2019; Mao et al, 2012; Ozcan & Eryilmaz, 2021; Özçoban et al, 2022; Rajeswari & SanjeevaReddy, 2020; Ramezani et al, 2017; Sapkota et al, 2022). Community workers (e.g.…”

“…lay health workers, facilitators, women groups leaders) were responsible for the delivery of the intervention in five trials (Baumgartner et al, 2021; George et al, 2020; Rotheram-Borus, Richter et al, 2014; Rotheram-Borus, Tomlinson et al, 2014; Sanfilippo et al, 2020; Tripathy et al, 2010), and one study employed a yoga instructor (Rong et al, 2021) (Table 1). In terms of active ingredients, most interventions ( n = 7) included techniques derived from cognitive behavior therapy (CBT)(Abhari et al, 2021; Baumgartner et al, 2021; Koçak et al, 2021; Li et al, 2019; Mao et al, 2012; Ramezani et al, 2017; Sanfilippo et al, 2020), followed by problem-solving techniques in four studies (Asnani et al, 2021; George et al, 2020; Sapkota et al, 2022; Tripathy et al, 2010), and interpersonal theory techniques in two trials (Gao et al, 2010, 2015). Psychoeducation was implemented in four RCTs (Chaharrahifard et al, 2021; Özçoban et al, 2022; Rotheram-Borus, Tomlinson et al, 2014; Vargas-Porras et al, 2021).…”

Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions

“…Table 2 summarizes the characteristics of the included 23 RCTs published between 2002 and 2021. Most were conducted in the US (21 studies), with 1 study each in Australia and Jamaica . Twenty-one studies used a 2-arm RCT design.…”

“…Most were conducted in the US (21 studies), with 1 study each in Australia and Jamaica . Twenty-one studies used a 2-arm RCT design. In addition, most studies (12 [52%]) reported that a control group received usual care.…”