Preliminary effectiveness and feasibility of an integrated hope techniques and narrative-based card game intervention for pediatric cancer patients in China : a randomized controlled trial

Abstract

Background: Spiritual well-being is the fourth dimension of well-being for pediatric cancer patients. A high level of spiritual well-being can protect them from psychological symptoms. Few interventions, however, have been focused on the spiritual dimension among pediatric patients with cancer. This study aimed to examine the feasibility and preliminary effectiveness of an integrated hope techniques and narrative-based card game (HT-NCG) intervention for pediatric cancer patients on spiritual and psychological well-being and quality of life (QoL). Methods: A total of 60 Chinese pediatric cancer patients aged 12–17 years were recruited from the pediatric oncology ward of Hunan Children’s Hospital, China. Among them, 30 participants were randomized to the experimental group and received four sessions of the HT-NCG intervention. Another 30 participants were allocated to the control group and received a placebo intervention. Spiritual well-being, hope, anxiety, depressive symptoms, and QoL were assessed at baseline (T0), post-intervention (T1), and at 1-month (T2) and 3-month (T3) follow-up. Assessors were blinded to the group allocation. The feasibility outcomes and results from generalized estimating equations were reported. Results: The feasibility of the HT-NCG intervention was demonstrated by a high recruitment rate (80%), high attendance rates in both groups, and a low attrition rate (20.0%) at 3 months. No adverse events were reported. At the 3-month follow-up, patients in the intervention group showed significantly greater improvement in spiritual well-being (T3 Β = 5.99; 95% CI, 0.27, 11.75; p = 0.042) and a greater reduction in depressive symptoms (T3 Β = − 6.41; 95% CI, − 12.75, − 0.07; p = 0.047) compared with the control group. Conclusions: This study supports that the HT-NCG is a feasible intervention among pediatric patients with cancer. This intervention can effectively improve spiritual well-being and decrease depressive symptoms in this patient population with a sustainable effect to three-month follow-up. The HT-NCG may help address the spiritual needs and improve spiritual well-being of pediatric cancer patients. This short, engaging, and relaxing card game intervention is concise and structured and can be easily disseminated, making it highly applicable in clinical settings.