Problem-solving skills training may improve parental psychosocial outcomes

For parents of children with chronic health conditions (CHCs), problem-solving skills training (PSST) is associated with improvement in parental, pediatric, and family psychosocial outcomes, according to a review published online Jan. 2 in JAMA Pediatrics.

Tianji Zhou, Ph.D., from the Xiangya School of Nursing at Central South University in Changsha, China, and colleagues conducted a systematic review of randomized clinical trials (RCTs) to examine the associations of PSST for parents of children with CHCs with parental, pediatric, and family psychosocial outcomes. Twenty-three RCTs involving 3,141 parents were included in the systematic review; 21 were eligible for meta-analysis.

The researchers found that PSST was significantly associated with improvements in parental outcomes, including problem-solving skills, depression, distress, posttraumatic stress, parenting stress, and quality of life (QOL; standardized mean differences [SMDs], 0.43, −0.45, −0.61, −0.39, −0.62, and 0.45, respectively).

PSST was associated with better QOL and fewer mental problems for children (SMD, 0.76 and −0.51, respectively) and with less parent-child conflict (SMD, −0.38). PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC in subgroup analysis. PSST delivered online was associated with significant improvements in most outcomes.

"Our findings on children- and intervention-level characteristics may guide the design and delivery of future PSST by presenting information on factors associated with effectiveness," the authors write.