Effectiveness of digital health on psychological well-being in parents of children with cancer: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

When children are diagnosed with cancer, their parents often face psychological challenges such as post-traumatic stress disorder, anxiety, and depression, impacting both their quality of life and the child’s prognosis. With advancements in information technology, digital health shows promise for providing psychological support to this group. However, its effectiveness remains unclear.

OBJECTIVE

This study aims to assess the efficacy of digital health in addressing post-traumatic stress disorder, anxiety, and depression among parents of children with cancer.

METHODS

Full-text randomized controlled trials were reviewed in six databases (PubMed, Embase, Web of Science, CENTRAL, PsycINFO, and CINAHL Plus) from database inception to March 2025. In addition, clinical trial registries and web-based grey literature sources were searched, and relevant references were manually reviewed. Two authors independently screened studies and extracted relevant data. Methodological quality was assessed using the Cochrane Risk of Bias version 2.0 (RoB 2) tool. Standardized mean differences and 95% confidence intervals were calculated using Review Manager 5.4 to estimate intervention effects. Additionally, subgroup analyses were conducted to assess potential sources of heterogeneity, while sensitivity analyses were performed to evaluate the robustness of the findings.

RESULTS

Nine randomized controlled trials with a total of 727 participants were included. The meta-analysis revealed that digital health improved post-traumatic stress disorder [SMD= -0.37, 95%CI -0.61, -0.13, P = 0.003], anxiety [SMD= -0.42, 95%CI -0.65, -0.18, P<0.001], and depression [SMD= -0.47, 95% CI -0.62, -0.32, P<0.001] among parents of children with cancer. Subgroup analysis indicated that both intervention format (websites vs. apps) and intervention duration (≤ 10 weeks vs. >10 weeks) had a positive impact on post-traumatic stress disorder and depression in this population. Notably, for anxiety outcomes, app interventions and extended-duration protocols (> 10 weeks) demonstrated superior efficacy. Sensitivity analyses confirmed the robustness of these findings.

CONCLUSIONS

Digital health demonstrates promise in ameliorating post-traumatic stress disorder, anxiety, and depression among parents of children with cancer. Larger, high-quality prospective studies are needed to validate these findings.