Effects of an intervention for fear of progression in childhood cancer patients and their parents: results of a randomized clinical trial

Abstract Background: For pediatric oncology patients and their parents, Fear of Progression (FoP) is a main psychosocial burden. While promising programs for adult patients exist, the specific needs in pediatrics have not been addressed yet. We developed an intervention and examined its effectiveness in a small sample. Methods: 29 families with a child with cancer in acute treatment or follow-up care and elevated FoP-levels participated. The intervention consists of psychoeducation, anxiety confrontation, and resource activation and is proofed in a randomized control study (RCT) with a wait list group who received treatment as usual (tau). All participants completed questionnaires on FoP and secondary outcomes (depression, quality of life, anxiety, post-traumatic stress symptoms) at different time points. We calculated Mann-Whitney-U-tests for between and within group comparisons as well as multiple regression to explore differential effectiveness. Results: There was a significant difference in FoP after intervention/tau between the two groups (W=62, p=.023) with high effect size (g=-0.855, 95% CI [-1.596;-0.115]). The pre-post and follow-up comparison showed that parental (W=462.5, p≤.001, g=0.855; 95% CI[0.517;1.193]) but not child´s (W=15, p=.438) FoP decreased significantly after intervention, and vice versa after follow-up (parents: W=251.5, p=.953; children: W=21, p=.034, g=0.244; 95% CI [0.039;0.449]). Time since diagnosis may influence the intervention effect (β=-0.447; p≥.004). Discussion: The intervention can significantly reduce parental FoP and seems promising for children. However, a major limitation of our study is the small sample size. Conclusion: The intervention represents an initial approach to treat elevated FoP in pediatric oncology.