Currently submitted to: JMIR Cancer
Date Submitted: Jun 30, 2026
Open Peer Review Period: Jul 22, 2026 - Sep 16, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluating Day-Level and Long-Term Mental Health Changes of a Psychosocial Aftercare Stay in Children with Cancer and Chronic Illnesses and Their Families: A Longitudinal EMA Study
ABSTRACT
Background:
Background. Children and adolescents with cancer or chronic illnesses, as well as their families, often experience considerable psychological distress that can persist long after intensive medical treatment ends. While the importance of family-oriented psychosocial aftercare is widely recognized, such programs remain under-evaluated, particularly in German-speaking countries, and the day-to-day mechanisms underlying their effects are largely unknown.
Objective:
Objective. The psychological distress faced by pediatric cancer patients or chronically ill children and their families requires specialized psychosocial aftercare. Thus, we investigated whether participation in family-oriented psychosocial aftercare (at the Sonneninsel Seekirchen) positively affects mental health outcomes from baseline to post-intervention and three-month follow-up, examined potential day-level mechanisms of change, and explored whether effects differ by family role.
Methods:
Methods. In total, 261 participants (affected children, siblings, mothers, fathers, and other caregivers) from 138 families reported depressive symptoms, fatigue, anxiety, anger, and sleep problems at pre, post and follow-up. Smartphone prompts assessed day-level psychological well-being, attendance at psychological consultations, and time spent with and closeness to family.
Results:
Results. Multilevel models accounting for assessments showed that depression, fatigue, anxiety, anger, and sleep problems were significantly lower at post (all ps < .001) and follow-up (all ps < .01) compared to pre. Day-level well-being increased during the stay (p < .001) and was not higher on days with psychological consultations (p = .486) but was positively associated with days families spend more time together (p < .01) and felt closer to each other (p < .001). Exploratory analyses suggested that effects were generally strongest in mothers.
Conclusions:
Conclusions. Participation in a psychosocial aftercare stay is associated with improvements across multiple mental health indicators. Positive family interactions represent a key resource for psychological well-being following a child’s illness. Although missing follow-up data limit conclusions about long-term effects, the results provide novel real-world evidence of the benefits of a family-oriented, resource-focused approach to psychosocial aftercare.
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