title: A systematic review of randomized controlled interventions for parents' distress in pediatric leukemia.
abstract: Objective. This review aims to summarize the existing evidence concerning interventions towards reducing stress in parents with a child with leukemia and their effect in child and family wellbeing. Methods. A systematic review strategy was conducted using MEDLINE covering the period January 1980 to June 2010. Results. Seven randomized controlled trials met the inclusion criteria including in total 1045 parents participants. A variety of cognitive-behavioral interventions problem-solving skills training programs have been used for managing distress in parents and children. Outcome measures are assessed by self-report, observer report, behavioral/psychological, and physiological measures. The most prominent methodological problems were the marked heterogeneity in stress measurement and the relative absence of proper measurement and adjustment of moderating and mediating factors. The largest effect has been obtained by combined cognitive-behavioral interventions with promising but limited evidence for several other psychological interventions. Conclusions. Recommendations for future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted.
authors.affiliation: Stress Management and Health Promotion Postgraduate Course, Medical School, University of Athens, 115 27 Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Bougea
authors.forename: C
authors.initials: C
authors.lastname: Darviri
authors.forename: E C
authors.initials: EC
authors.lastname: Alexopoulos
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