Development and Feasibility of a Web-based, Self-Help Psychosocial Intervention for Saudi Mothers of Children Recently Diagnosed with Cancer

Abstract

Abstract Mothers, often as the primary caregiver of children with cancer, experience elevated distress when faced with a child illness which could lead to comorbidity disorders, low quality of life and negatively influence a child’s psychological state. Therefore, standards for psychosocial care of children with cancer and their families are strongly recommended, offering caregivers of children with cancer early and ongoing assessment of their mental health needs and facilitating their access to appropriate interventions to optimise caregivers and child well-being. However, many barriers exist to delivering in-person interventions in this population including scheduling difficulties for caregivers impacting attendance of in-person interventions, challenges in accessing such interventions due to geographical distance from specialised paediatric cancer centres and a lack of specialists in this field. Using computer technology such as a web-based, self-help format could present a unique opportunity to address the common barriers to such in person-interventions and improve the mental health care of caregivers. Most previous studies were conducted in Western countries thereby limiting the generalisability of findings to different cultural contexts. Thus, there is a need to develop a web-based, self-help intervention which is culturally sensitive to Saudi mothers’ context. This thesis aims to address this gap through the conducting of four studies informed by the MRC framework and intervention mapping approach to inform the development and feasibility of a web-based, self-help psychosocial intervention for Saudi mothers of children recently diagnosed with cancer. Study One comprises interviews to understand the difficulties and needs experienced by Saudi mothers. 31 mothers expressed difficulties including anxiety (uncertainty and worry about the child’s condition), managing treatment, fear of chemotherapy impact, feeling depressed and struggling with child’s emotions and behaviour. Mothers further suggested the inclusion of religious and spiritual support and promoting positivity within the intervention. Study Two draws on the results from the literature review and Study One to inform the process of intervention development and creation of the initial version thereof; Study Three uses a panel of five professionals and two mothers to refine the initial version of the intervention using triangulation of interviews and survey. Participants rated the intervention high on usability and feasibility. They further provided important feedback concerning the intervention content and design. According to this study the intervention was refined, and an electronic version created; Study Four comprises a feasibility randomised controlled trial conducted to examine the feasibility, acceptability, and initial outcomes of the intervention, with promising results. As such, the participation rate (83%) was considered perfectly adequate and the drop out was fairly low. Mothers also positively appreciated using the intervention and provided further feedback and recommendations for improving the intervention.