(see Poster Gallery) Implementation and Evaluation of Bright Ideas Problem-Solving Skills Training for Mothers of Children with Cancer in South Korea

Background and Purpose: Mothers of children with cancer often report compromised well-being and psychological stress due to many challenges associated with children’s diagnosis and treatment. Bright IDEAS (BI) problem-solving skills training is an effective evidence-based intervention for improving problem-solving skills and alleviating psychological problems in caregivers of children with cancer. However, there has been limited implementation and evaluation of BI with mothers of children with cancer due to the lack of resources and awareness in South Korea. This study was the first to implement and quantitatively and qualitatively evaluate the impact of BI for mothers of children with cancer in South Korea.

Methods: Five sessions of BI were implemented individually online with 14 mothers of childhood cancer survivors. All participants were currently married and between 36 and 46 years old; 85.8% held a college degree, and the others held a high school degree. Most were housewives, and their children ranged from 5 to 13 years old. The most common diagnosis among their children was hematological cancer, followed by brain tumors, rhabdomyosarcoma, and other solid tumors. Their elapsed time since cancer diagnosis ranged from 2 to 11 years. Demographic and children’s medical information were obtained prior to the intervention. The Korean version of the Patient Health Questionnaire-9, Posttraumatic Stress Diagnostic Scale, Parenting Stress Index, Social Problem-Solving Inventory-Revised, and Posttraumatic Growth Inventory were administered at baseline prior to receiving BI and immediately following completion of BI sessions. Wilcoxon’s signed ranks test was used to determine whether scores for depressive symptoms, posttraumatic stress, parenting stress, social problem solving, posttraumatic growth changed from pre- to posttest. Additionally, three focus group interviews were conducted to qualitatively understand their changes in life after participating BI.

Results: Results show that mothers of children who completed the BI program reported significant decreases in depression (z = -2.671, p < .01), posttraumatic stress (z = -2.938, p < .01), and parenting stress (z = -2.834, p < .01) and increases in posttraumatic growth (z = -3.184, p < .01) after the intervention. Although not statistically significant, positive aspects of social problem solving (positive problem orientation and rational problem solving) improved, whereas negative aspects (negative problem orientation, impulsiveness or carelessness, and avoidance) decreased. Through qualitative interviews, five themes related to life changes after participation in BI were identified: (a) reducing family conflicts and recovering relationships with family members; (b) avoiding emotional responses toward stressful events; (c) developing rational coping strategies; (d) promoting self-care, which had been neglected; and (e) appreciating present life.

Conclusions and Implications: This study provided insight into adaptation and implementation of BI for mothers of children with cancer in South Korea. The findings suggest its effectiveness in improving psychological health and the potential role of enhancing social problem-solving skills, which can lead to improved quality of life among mothers of children with cancer. Further culturally appropriate adaptations of BI and implementations of multi-institutional randomized clinical trials can enhance the intervention with strong and consistent effects.