Efficacy of the integrative Body-Mind-Spirit group intervention for improving quality of life in parent-child dyads adjusting to atopic dermatitis: protocol for a randomised controlled trial

Victoria Ka Ying Hui, Celia Hoi Yan Chan, Yat Lui Fung, Cecilia Lai Wan Chan, Martha Sin Ki Luk, Victoria Ka Ying Hui, Celia Hoi Yan Chan, Yat Lui Fung, Cecilia Lai Wan Chan, Martha Sin Ki Luk

Abstract

Introduction: Atopic dermatitis (AD) is the most common childhood inflammatory skin problem affecting 15%-30% of children. Although AD adversely impacts the psychosocial well-being of children and their parent caregivers, parents' psychosocial well-being is seldom mentioned in most non-pharmacological education programmes. A family-based psychosocial intervention, Integrative Body-Mind-Spirit (I-BMS) intervention, is examined. This study compares the efficacy of two versions of the I-BMS intervention (one delivered to both parents and children; one delivered to parents only) with a health education active control (delivered to parents only) in promoting adaptive emotional regulation and quality of life of children with AD and their parent caregivers.

Methods and analysis: This is a three-arm, with equal randomisation, parallel randomised controlled trial. 192 parent-child dyads will be recruited through hospitals and non-governmental organisations in Hong Kong. Each dyad will complete an individual pre-group screening interview. Eligible dyads will be randomised in a ratio of 1:1:1 into one of the three arms. Each arm consists of six weekly sessions. A computer-generated list of random numbers will be used to perform randomisation. The primary outcomes are quality of life and emotional regulation. Assessments are administered at baseline, post-intervention and 6-week follow-up. Mixed factorial Analysis of Covariance (ANCOVAs) based on intention-to-treat principle will be conducted to examine the efficacy of the two I-BMS interventions. Structural equation modelling will be conducted to examine the parent-child interdependent effects of intervention.

Ethics and dissemination: Ethics approval was obtained from the Human Research Ethics Committee of the University of Hong Kong (EA2001001) and the Institutional Review Board of the Hospital Authority of Hong Kong (UW 21-400, KC/KE-20-0360/FR-2, NTEC-2021-0408). Consent will be sought from participating parents and children. Parental consent for child participants will also be obtained. Findings will be presented in peer-reviewed journals and at conferences in medical dermatology, paediatrics and social work.

Trial registration number: ClinicalTrials.gov Registry (NCT04617977).

Keywords: eczema; education & training (see medical education & training); mental health; paediatric dermatology.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Trial profile. I-BMS, Integrative Body–Mind–Spirit.

References

    1. Archer CB. Atopic eczema. Medicine 2013;41:341–4. 10.1016/j.mpmed.2013.04.002
    1. Fortson EA, Feldman SR, Strowd LC, eds. Management of atopic dermatitis: Methods and challenges. Cham, Switzerland: Springer International Publishing AG, 2017.
    1. Cheng NS, Chau PCJ, Hon KLE, et al. . Measuring the quality of life of the families of children with eczema in Hong Kong. Asia Pac Allergy 2019;9:1. 10.5415/apallergy.2019.9.e26
    1. Hon KL, Leung TF, Wong Y, et al. . Skin diseases in Chinese children at a pediatric dermatology center. Pediatr Dermatol 2004;21:109–12. 10.1111/j.0736-8046.2004.21203.x
    1. El-Heis S, Crozier SR, Healy E, et al. . Maternal stress and psychological distress preconception: association with offspring atopic eczema at age 12 months. Clin Exp Allergy 2017;47:760–9. 10.1111/cea.12910
    1. Drucker AM, Wang AR, Li W-Q, et al. . The burden of atopic dermatitis: summary of a report for the National eczema association. J Invest Dermatol 2017;137:26–30. 10.1016/j.jid.2016.07.012
    1. Halvorsen JA, Lien L, Dalgard F, et al. . Suicidal ideation, mental health problems, and social function in adolescents with eczema: a population-based study. J Invest Dermatol 2014;134:1847–54. 10.1038/jid.2014.70
    1. Magin P. Appearance-related bullying and skin disorders. Clin Dermatol 2013;31:66–71. 10.1016/j.clindermatol.2011.11.009
    1. Xie Q-W, Dai X, Tang X, et al. . Risk of mental disorders in children and adolescents with atopic dermatitis: a systematic review and meta-analysis. Front Psychol 2019;10:12. 10.3389/fpsyg.2019.01773
    1. Andersson NW, Hansen MV, Larsen AD, et al. . Prenatal maternal stress and atopic diseases in the child: a systematic review of observational human studies. Allergy 2016;71:15–26. 10.1111/all.12762
    1. Ho RCM, Giam YC, Ng TP, et al. . The influence of childhood atopic dermatitis on health of mothers, and its impact on Asian families. Pediatr Allergy Immunol 2010;21:501–7. 10.1111/j.1399-3038.2009.00972.x
    1. Chan CWH, Law BMH, Liu Y-H, et al. . The association between maternal stress and childhood eczema: a systematic review. Int J Environ Res Public Health 2018;15:395. 10.3390/ijerph15030395
    1. Dodington SR, Basra MKA, Finlay AY, et al. . The dermatitis family impact questionnaire: a review of its measurement properties and clinical application. Br J Dermatol 2013;169:31–46. 10.1111/bjd.12232
    1. Fung Y-L, Leung H-T, Chan CHY, et al. . Efficacy of integrative Body-Mind-Spirit group intervention for parents of children with eczema: a randomized, wait-list controlled clinical trial. Res Soc Work Pract 2020;30:623–32. 10.1177/1049731520905643
    1. Eisenberg N, Cumberland A, Spinrad TL. Parental socialization of emotion. Psychol Inq 1998;9:241–73. 10.1207/s15327965pli0904_1
    1. Berg CA, Upchurch R. A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychol Bull 2007;133:920–54. 10.1037/0033-2909.133.6.920
    1. Farasat H. Cochrane review update: psychological and educational interventions for atopic eczema in children. Community Pract 2014;87:11–12.
    1. Ersser SJ, Latter S, Sibley A, et al. . Psychological and educational interventions for atopic eczema in children. Cochrane Database Syst Rev 2007;3:1. 10.1002/14651858.CD004054.pub2
    1. Chan CLW, Ng SM, Ho RTH, et al. . East meets West: applying eastern spirituality in clinical practice. J Clin Nurs 2006;15:822–32. 10.1111/j.1365-2702.2006.01649.x
    1. Chan CHY, Chan CLW, Ng EHY, et al. . Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: a prospective randomized controlled study. Psychol Psychother 2012;85:356–73. 10.1111/j.2044-8341.2011.02040.x
    1. Chan CHY, Chan THY, Chan CLW. Translating Daoist concepts into integrative social work practice: an empowerment program for persons with depressive symptoms. J Relig Spiritual Soc Work 2014;33:61–72. 10.1080/15426432.2014.873662
    1. Lee MY, CCHY C, Chan CLW. Integrative body-mind-spirit social work : An empirically based approach to assessment and treatment. 2nd ed. New York, NY: Oxford University Press, 2018.
    1. Fung YL, Lau BHP, Tam MYJ, et al. . Protocol for psychosocial interventions based on integrative Body-Mind-Spirit (IBMS) model for children with eczema and their parent caregivers. J Evid Based Soc Work 2019;16:36–53. 10.1080/23761407.2018.1545618
    1. Xie Q-W, Chan CH-yan, Lau BH-po, CH-y C, BH-p L, et al. . Effectiveness of an integrative Body-Mind-Spirit group intervention in improving the skin symptoms and psychosocial well-being in children living with atopic dermatitis: a randomized-waitlisted controlled trial. Child Youth Serv Rev 2020;110:104739. 10.1016/j.childyouth.2019.104739
    1. Ridd MJ, King AJL, Le Roux E, et al. . Systematic review of self-management interventions for people with eczema. Br J Dermatol 2017;177:719–34. 10.1111/bjd.15601
    1. Chan A-W, Tetzlaff JM, Gøtzsche PC, et al. . Spirit 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ 2013;346:e7586. 10.1136/bmj.e7586
    1. Finlay A. Family Dermatology Life Quality Index (FDLQI) - Different language versions 2018. Available:
    1. Basra MKA, Sue-Ho R, Finlay AY. The family dermatology life quality index: measuring the secondary impact of skin disease. Br J Dermatol 2007;156:528–38. 10.1111/j.1365-2133.2006.07617.x
    1. Finlay A. Children’s Dermatology Quality of Life Index - Chinese (all versions), 2019. Available:
    1. Lewis-Jones MS, Finlay AY. The Children’s Dermatology Life Quality Index (CDLQI): initial validation and practical use. 1995;132:942–9. 10.1111/j.1365-2133.1995.tb16953.x
    1. Chuh AAT. Validation of a Cantonese version of the children's dermatology life quality index. Pediatr Dermatol 2003;20:479–81. 10.1111/j.1525-1470.2003.20604.x
    1. Garnefski N, Kraaij V. Cognitive emotion regulation questionnaire – development of a short 18-item version (CERQ-short). Pers Individ Dif 2006;41:1045–53. 10.1016/j.paid.2006.04.010
    1. Liu W, Chen L, Blue PR. Chinese adaptation and psychometric properties of the child version of the cognitive emotion regulation questionnaire. PLoS One 2016;11:e0150206. 10.1371/journal.pone.0150206
    1. Orgilés M, Morales A, Fernández-Martínez I, et al. . Validation of the short version of the cognitive emotion regulation questionnaire for Spanish children. J Child Health Care 2019;23:87–101. 10.1177/1367493518777306
    1. Leung CM, Wing YK, Kwong PK, et al. . Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton rating scale of depression. Acta Psychiatr Scand 1999;100:456–61. 10.1111/j.1600-0447.1999.tb10897.x
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70. 10.1111/j.1600-0447.1983.tb09716.x
    1. Ebesutani C, Reise SP, Chorpita BF, et al. . The revised child anxiety and depression Scale-Short version: scale reduction via exploratory bifactor modeling of the broad anxiety factor. Psychol Assess 2012;24:833–45. 10.1037/a0027283
    1. Chorpita BF, Ebesutani C, Spence SH. Revised Children’s Anxiety and Depression Scale - Chinese (Youth version), 2020. Available:
    1. Leung DY, Lam T-H, Chan SS. Three versions of perceived stress scale: validation in a sample of Chinese cardiac patients who smoke. BMC Public Health 2010;10:513. 10.1186/1471-2458-10-513
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385–96. 10.2307/2136404
    1. White BP, White BP. The perceived stress scale for children: a pilot study in a sample of 153 children. Int. J. Pediatr. Child Health 2014;2:45–52. 10.12974/2311-8687.2014.02.02.4
    1. Furman W, Gibson RS. Identifying the links between parents and their children’s sibling relationships. In: Schulman S, ed. Close relationships in social-emotional development. Norwood, NJ: Ablex, 1995: 95–108.
    1. Gerdes AC, Hoza B, Pelham WE. Attention-Deficit/Hyperactivity disordered boys' relationships with their mothers and fathers: Child, mother, and father perceptions. Dev Psychopathol 2003;15:363–82. 10.1017/S0954579403000208
    1. Centre of Evidence Based Dermatology . POEM — Patient Oriented Eczema Measure - Translation (Chinese) n.d. Available:
    1. Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective. Arch Dermatol 2004;140:1513–9. 10.1001/archderm.140.12.1513
    1. Greenley JR, Greenberg JS, Brown R. Client Experiences Questionnaire. In: Fischer J, Corcoran K, eds. Measures for clinical practice and research: a sourcebook. New York, NY: Oxford University Press, 2007: 147–9.
    1. Armijo-Olivo S, Warren S, Magee D. Intention to treat analysis, compliance, Drop-outs and how to deal with missing data in clinical research: a review. Physical Therapy Reviews 2009;14:36–49. 10.1179/174328809X405928

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