Virtual intervention helps patients, parents balance COVID-19, cystic fibrosis

Virtual psychological support improved depression and stress levels for patients with cystic fibrosis and their parents during the Italian COVID-19 pandemic lockdown, according to a study.

“During the COVID crisis, rates of depression and anxiety were highly elevated in patients with cystic fibrosis and parents, with many scoring in the moderate to severe range. Results showed this brief intervention was effective in reducing stress and symptoms of depression in both groups,” Sonia Graziano, PsyD, a psychologist at the Bambino Gesù Children’s Hospital, Rome, said during her virtual presentation at the North American Cystic Fibrosis Conference. “Our lockdown in Italy was very restrictive. ... For example, only one person per family was allowed to go shopping at the time and social activities were forbidden. ... As the pandemic spread throughout Italy and Europe, new mental health concerns were raised about people with cystic fibrosis and their parents, who were already at risk for depression and anxiety.”

In the study of 16 adolescents and 14 parents of children with cystic fibrosis, Graziano and colleagues conducted four sessions via Zoom, each consisting of 30 to 40 minutes of psychological support. All individuals electronically completed the eight-question Public Health Questionnaire (PHQ-8) for depression and the Generalized Anxiety Disorder seven-item (GAD-7) questionnaire, before and after assessment.

“The intervention focused on self-care such as relaxation, coping skills such as cognitive refrain, which facilitates more positive thoughts and was specifically tailored to the individual emotional concerns,” Graziano said. Providers focused on maintaining regular routines such as getting dressed and getting enough sleep, limiting exposure to the news regarding COVID-19 and using technology to connect with family and friends, and lessen feelings of isolation.

“A high percentage of patients in both groups scored in the clinical elevated range on the screening measure prior to the intervention,” Graziano said.

For patients, depression and anxiety measured at 71%; for parents, depression was 57% and anxiety was 79%. Twenty percent to 40% of both groups scored in the moderate to severe range in depression and anxiety.

“The results of these brief intervention demonstrated a statistically significant reduction in stress ... and depression,” she said.

Patient depression scores went from 8 in the pretest to 4.7 in the posttest (P < .05) while their stress scores went from 7.1 to 4.9 (P < .01). Parent depression scores fell from 6.4 to 5.1 (P < .05) and their stress scores fell from 7.8 to 5.7 (P < .001).

“It is possible that anxiety did not decrease as much because people were still living each day with the crisis. Triggers for anxiety were ubiquitous — the news, mortality news, economic recession and extreme isolation in Italy may also have raised the levels of anxiety,” Graziano said. “This four-session psychological support intervention was brief but highly effective and was rated as feasible and satisfactory by consumers.”