Peer-reviewed article
Effects of eHealth interventions on depression, anxiety, quality of life, and post-traumatic stress symptoms among parents of children with cancer: A meta-analysis of randomized controlled trials.
Jianmei Zhu, Xiaofei Chen, Yaping Ding ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This meta-analysis synthesizes evidence from 13 randomized controlled trials on eHealth interventions for parents of children with cancer, examining effects on parental depression, anxiety, quality of life, and post-traumatic stress. The study found that eHealth interventions significantly reduced depression and anxiety in parents, though effects on quality of life were not significant and evidence on post-traumatic stress was unstable. The certainty of evidence ranged from moderate for depression to very low for other outcomes, and the authors call for more rigorous trials with better reporting and longer follow-up periods.
Key points
- eHealth interventions significantly reduced depression (SMD = -0.56) in parents of children with cancer
- Anxiety was significantly reduced (SMD = -0.66), though certainty of evidence was very low
- Quality of life improvement was not statistically significant
- Post-traumatic stress symptoms showed reduction but this was not stable in sensitivity analysis
- Thirteen RCTs involving 1,022 parents were included in the meta-analysis
Limitations
This study focuses on parental mental health outcomes rather than child well-being directly. The meta-analysis identified moderate-to-very-low certainty of evidence, and results for anxiety and post-traumatic stress were unstable across sensitivity analyses.
Abstract
OBJECTIVE: To synthesize evidence from randomized controlled trials on the effects of eHealth interventions on depression, anxiety, quality of life, and post-traumatic stress symptoms in parents of children with cancer. METHODS: PubMed, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Web of Science, CNKI, VIP, and SinoMed were searched from inception to 31 January 2026. Two reviewers independently screened studies, extracted data, assessed risk of bias using RoB 2 and rated certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). For family-randomized trials, standard errors were inflated using a design effect with a primary intraclass correlation coefficient (ICC) of 0.50; sensitivity analyses used ICCs of 0.10, 0.25, and 0.75. Exploratory subgroup analyses, sensitivity analyses, and publication bias assessments were conducted when appropriate. RESULTS: Thirteen randomized controlled trials involving 1022 parents were included in the meta-analysis. eHealth interventions significantly reduced depression (standardized mean difference [SMD] = -0.56, 95% confidence interval [CI] -0.76 to -0.36) and anxiety (SMD = -0.66, 95% CI -1.12 to -0.20). The effect on quality of life was not statistically significant (SMD = 0.36, 95% CI -0.06 to 0.78). A significant reduction in post-traumatic stress symptoms was observed (SMD = -0.48, 95% CI -0.84 to -0.11), but this result was not stable in sensitivity analysis. For anxiety, excluding one influential study reduced the pooled effect to -0.45 (95% CI -0.62 to -0.27) and I 2 from 80.5% to 28.5%. Effect directions, statistical significance, and certainty ratings were unchanged across ICC assumptions of 0.10-0.75. The certainty of evidence was moderate for depression and very low for anxiety, quality of life and post-traumatic stress symptoms. CONCLUSIONS: eHealth interventions may help reduce depression in parents of children with cancer. Evidence for anxiety, quality of life and post-traumatic stress symptoms remains limited and should be interpreted with caution. More rigorous randomized controlled trials with clearer intervention reporting, longer follow-up, and better adherence data are needed. SYSTEMATIC REVIEW REGISTRATION: CRD420251236158.