OTSystematic ReviewChild: care, health and development2019

Experiences of interventions aiming to improve the mental health and well-being of children and young people with a long-term physical condition: A systematic review and meta-ethnography.

Liz Shaw, Darren Moore, Michael Nunns and 9 others

PMID 31339591

WHAT IT FOUND

Children with long-term physical conditions, families and staff valued interventions that were accessible, safe, peer-connected, everyday-life focused and confidence-building.

These were themes, not proof interventions improve mental health.

Key findings

01Five constructs described what mattered to participants: getting in and staying in, a therapeutic foundation, social support, a hopeful alternative and empowerment.

02Support from peers, staff and family was described as helping participants feel less isolated and remain engaged.

03Meeting peers and taking part in everyday activities were described as supporting hope, and empowerment was described as increased ability to manage themselves and higher self-esteem.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

This is a synthesis of qualitative experiences, not an effectiveness review. Symptoms of mental ill health were not routinely measured in the included interventions. Only 13 articles scored positively on at least 12 quality appraisal questions. The theoretical or ideological perspective of the author was not reported in 45 articles, so its influence could not be determined. Children and young people with learning or intellectual disabilities were excluded. The review included many different interventions and conditions, so the constructs may not apply to every intervention or every child with a long-term physical condition. There was no data about participants' experiences of mental health difficulties, so it is unclear how findings apply to different mental health needs. Only four included studies had a qualitative evaluation as part of a randomized controlled trial. Because many different intervention components were included together, the contribution of any single component cannot be separated.

Declared interests

The funder is named as the National Institute for Health Research.

The easy way to misread this

Do not read these constructs as proof that any intervention improves mental health. This review synthesised experiences of many different interventions, and symptoms of mental ill health were not routinely measured. Only four included studies had a qualitative evaluation as part of a randomized controlled trial.

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