Η επίδραση της προοδευτικής μυϊκής χαλάρωσης και του κατευθυνόμενου οραματισμού στη μείωση των συμπτωμάτων αγχώδους διαταραχής στους γονείς παιδιών με κακοήθεια

Abstract

Introduction: Illness, especially malignancy, particularly when it happens to a child, is a source of intense stress in families. For most parents, the word malignancy is still associ-ated with death. Anxiety, depression, denial, anger and low self-esteem are some of the emotional reactions experienced by parents and often occur in response to the fear of a future relapse or uncertainty about the future evolution of the disease in children. The mental tension of the parents is a concern not only for their parents themselves, but also for children-patients, because the stress levels of parents associated with treatment re-sponses and adaptation of children with malignancy. For this reason, it is extremely im-portant to involve parents in their child's care, both in terms of reducing anxiety to parents that do not adversely affect their child, and to be well prepared to help their child address-ing behavior during care. According to the results of Randomized Clinical Trial (RCT) involving relaxation interventions to reduce anxiety in parents of children with malignan-cy, emerged some positive information concerning its effect. However further research is needed to assess the effectiveness of interventions in relation to relaxation to reduce anxi-ety in parents of children with malignancy. Aim: To examine the effect of Progressive Muscle Relaxation (PMR) and Guided Image-ry (GI) interventions, in reducing anxiety levels among parents of children with cancer on the treatment initiation phase. Sample and Method: This RCT was held in the public hospitals of Nicosia and Athens. The sample consisted of 54 parents of children hospitalized with malignancies, who met the inclusion criteria. Participants were randomly assigned to both PMRT and GI (n=29), or control group (n=25). Control group did not receive any additional intervention beyond the standard care of the unit. Outcome measures included the Hamilton Anxiety Scale, POMs Brief questionnaire and The Ways of Coping Inventory at 3 weeks‘ time (pre and post intervention) and physiological parameters (Blood Pressure, Heart Rate, Skin Tem-perature) every week pre and post intervention. Results: In ‘Hamilton Anxiety Scale‘ showed significant differences of mean in interven-tion group between Σμ ηαζ Σ1 in comparison with the control group. The effect size for the intervention group was small to moderate (Cohen's d = 0,37). In the intervention group the correlation coefficient of the score on the Hamilton anxiety scale in the Σμ and in the T1 measurement was r = 0,843 (p <0,001) and in the control group r = 0,847 (p <0,001). In the intervention group and T1, there was a statistically significant reduction in anxious mood (p = 0,036), in tension (p = 0,006), in insomnia marginally (p = 0,058), in intellec-tual (difficulty in concentration) (p = 0,001 ) in respiratory symptoms (p = 0,031) and gas-trointestinal symptoms (p = 0,036). Σμ ιέβεεμξ ηδξ επίδναζδξ βζα ηδκ μιάδα πανέιααζδξ ήηακ ιζηνυ πνμξ ιέηνζμ (0,37). In the control group there was a statistically significant decrease in depressive mood (p = 0,017), in somatic symptoms (sensory) (p = 0,, 047) and in respiratory symptoms (p = 0,030). In 'POMs Brief' scale, there was a statistically signif-icant difference in tension at the Σμ measurement and T1 (p = 0,027). In the individual subscales of the questionnaire POMs Brief, the parents in T1 measurement in the inter-vention group reported significantly less sad (p = 0,001), weary (p = 0,026), forgetful (p = 0,050), significantly less tense and anxious (p = 0,031 ) and significantly more active (p = 1,000). The ANCOVA analysis of the overall mood in the last week including current day parents in T1 measurement with a constant factor in the group that owns the parent (inter-vention and control) as a covariate in the overall disposition the measurement showed that the interaction of group and disposal were statistically significant F (1,44) = 11,65, p = 0,001. In the intervention group and linear regression analysis with the dependent variable available to parents at T1 measurement showed itself the-efficacy of parents to face their own problems to interpret the 45% of the observed variability of mood. More specifically, for each increase of one unit-efficacy at the estimated average price of disposal increased by 0.68 units. In the ‗Ways Of Coping Inventory‘ there was no statistically significant dif-ferences in any of the factors in the Σμ and T1 measurement in both the intervention and control group. Comparison of mean differences (Pretest score – posttest score) (one-way repeated measures ANOVA) showed significant strong differences in Systolic Blood Pressure (p=0,030) (Partial Eta Squared=0,262), in Heart Rate (p=0,003) (Partial Eta Squared=0,401) and Skin Temperature (p<0,001) (Partial Eta Squared=0,755). Conclusions: This is one of the first studies in the literature demonstrating the beneficial nature of relaxation to reduce anxiety and improve mood in parents of children with ma-lignancy. This research was supported by the acceptance, the effectiveness and the impact of relaxation techniques (PMR, GI) to reduce the anxiety of the parents of children with malignancy.