JMIR Publications

ABSTRACT

Background:

Parenting stress is greater in the parents of children with chronic illness than those of healthy children and is related to poorer psychological adjustment in both parents and children. This paper reports the evaluation of a web-based tool that provides information and practical skills to help increase parents’ confidence in managing their child’s illness and reduce parenting stress.

Objective:

To evaluate the benefits of a web-based tool (“WebParC”) for parents of children with recently diagnosed juvenile idiopathic arthritis (JIA).

Methods:

A multi-centred randomised controlled trial was conducted in paediatric rheumatology centres. Parents of children aged ≤12 years, who had been diagnosed within JIA within the previous six months, were recruited when they attended clinic with their child. They were randomised to the Intervention (WebParC access plus standard care) or the Control (standard care alone), and followed up 4-months and 12-months post-randomisation. Where both parents participated, they were randomised ‘by household’ to the same trial arm. The WebParC intervention consists of information about JIA and its treatment plus a toolkit, based on cognitive-behavioural therapy, to help parents develop skills to manage JIA-related issues. The primary outcome was the self-report Pediatric Inventory for Parents (PIP) measure of illness-related parenting stress. Secondary outcomes were: parental mood, self-efficacy, coping, effectiveness of participation in their child’s healthcare, satisfaction with healthcare and child health-related quality of life (HRQoL).

Results:

A total of 203 ‘households’ were randomised to the Intervention (n=100) or Control (n=103) arm. Follow-up assessments were completed by 133 (65.5%) at 4-months (60 Intervention, 73 Control) and 124 (61.1%) (58 Intervention, 66 Controls) at 12-months. A main effect of trial-arm was found on the PIP; Intervention participants reported less frequency (subscales Communication F=5.37, P=.02; Role Function F=5.40, P=.02) and difficulty (subscales Communication F=7.43, P=.006; Medical care F=4.04, P=.04; Role Function F=4.37, P=.04) of illness-related stressful events than Control participants.

Conclusions:

The WebParC website for parents of children with JIA reduced illness-related parenting stress. Clinical Trial: International Standard Randomized Controlled Trial Number (ISRCTN): 3159730; http://www.isrctn.com/ISRCTN13159730.