Family Psychosocial Risk Screening in Infants and Older Children in the Acute Pediatric Hospital Setting Using the Psychosocial Assessment Tool

Abstract PURPOSE: The revised Psychosocial Assessment Tool (PATrev) is a common family-level risk-based screening tool for pediatric oncology that has gained support for its ability to predict, at diagnosis, the degree of psychosocial support a family may require throughout the treatment trajectory. However, ongoing screening for symptoms and concerns (e.g., feeling alone, understanding treatment) remain underutilized. Resource limitations necessitate triaging and intervention based on need and risk. Given the widespread use of the PATrev, we sought to explore the association between family psychosocial risk, symptom burden (as measured by the revised Edmonton Symptom Assessment System; ESAS-r), and concerns (as measured by the Canadian Problem Checklist; CPC). METHODS: Families (n = 85) with children between 2–18 years of age (M = 11.98, male: 62.4%) on or off treatment for cancer were recruited from the Alberta Children’s Hospital. One parent from each family completed the PATrev and the CPC. Participants 8–18 years of age completed the ESAS-r. RESULTS: Risk category (unviersal/low risk = 67.1%, targeted/intermediate risk = 21.1%, clinical/high risk = 5.9%), predicted symptom burden (F[2, 63.07] = 4.57, p = .014) and concerns (F[2, 80.08] = 16.34, p < .001), such that universal risk was associated with significantly lower symptom burden and fewer concerns. CONCLUSION: Family psychosocial risk is associated with cross-sectionally identified concerns and symptom burden, suggesting that resources might be prioritized for families with the greatest predicted need. Future research should evaluate the predictive validity of the PATrev to identify longitudinal concerns and symptom burden throughout the cancer trajectory.

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Identifying Psychosocial Risk Factors Among Families of Children With Craniofacial Conditions

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617748010 ◽

2018 ◽

Vol 55 (4) ◽

pp. 536-545 ◽

Cited By ~ 10

Author(s):

Canice E. Crerand ◽

Hillary M. Kapa ◽

Jennifer Litteral ◽

Gregory D. Pearson ◽

Katherine Eastman ◽

...

Keyword(s):

Child Behavior Checklist ◽

Cleft Lip And Palate ◽

Assessment Tool ◽

Risk Group ◽

Screening Instrument ◽

Self Report ◽

Psychosocial Risk ◽

Psychosocial Assessment ◽

Retest Reliability ◽

Test Retest Reliability

Objective: To evaluate the psychometric properties of the Psychosocial Assessment Tool–Craniofacial Version (PAT-CV), a screening instrument for psychosocial risk in families of children with craniofacial conditions, and to examine risk classification of patients in a craniofacial population. Design: Prospective, cross-sectional, single-center study. Setting: Interdisciplinary cleft lip and palate/craniofacial center at a US children’s hospital. Participants: Parents/caregivers (n = 242) of 217 children ages 1 month to 17 years being treated for a congenital syndromic or nonsyndromic craniofacial condition completed the PAT-CV and validating measures from July 2015 to July 2016. The PAT-CV was completed by 121 caregivers a second time to assess test-retest reliability. Main Outcome Measures: PAT-CV, Child Behavior Checklist, Adult Self-Report, Pediatric Quality of Life Inventory, Craniofacial Experiences Questionnaire, and Family Environment Scale. Results: Construct validity of the PAT-CV was supported by significant correlations ( P < .001) between PAT-CV total and subscale scores and the validated measures. PAT-CV total scores categorized 59.9% of families within the universal risk group, 32.3% within the targeted risk group, and 7.8% within the clinical range. Good criterion validity was indicated by significantly higher scores ( P < .0001) obtained on the validated measures for those in the targeted and clinical risk groups. Internal consistency (Cronbach’s α = 0.86) and test-retest reliability for the PAT-CV total score ( r = 0.77, P < .0001) were acceptable. Conclusions: The PAT-CV appears to be a reliable and valid screening instrument for psychosocial risk. Accurate identification of risk and implementation of appropriate interventions may contribute to improvements in medical and psychosocial outcomes.

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Psychosocial risk in families of infants undergoing surgery for a serious congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951113000760 ◽

2013 ◽

Vol 24 (4) ◽

pp. 632-639 ◽

Cited By ~ 47

Author(s):

Simone J. Hearps ◽

Maria C. McCarthy ◽

Frank Muscara ◽

Stephen J. C. Hearps ◽

Kylie Burke ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Parent Education ◽

Congenital Heart ◽

Assessment Tool ◽

Acute Stress ◽

Total Sample ◽

Psychosocial Risk ◽

Psychosocial Assessment ◽

Optimal Parenting

AbstractObjective:The aim of this study was to explore the acute psychosocial risk in families with infants undergoing surgery for a congenital heart disease and, secondarily, to explore the psychosocial impact of antenatal versus post-natal diagnoses.Method:The study sample comprised 39 caregivers (28 mothers) of 29 children diagnosed with a congenital heart disease and requiring surgery within the first 4 weeks of life. Psychosocial risk was measured using the Psychosocial Assessment Tool, which was adapted to include four novel items examining infant risk factors, namely, sleeping, feeding, crying, and bonding difficulties. Parents’ psychosocial risk was measured within 4 weeks after their child's surgery and stratified into a three-tiered framework: Universal, Targeted, and Clinical risk.Results:Of the total sample, 61.5% of parents were classified as Universal, that is, at lowest risk; 35.9% as Targeted, and 2.6% as Clinical. The within-family parent total Psychosocial Assessment Tool score correlations were non-significant, and there were no differences between families of infants who received post-natal versus antenatal diagnosis or single ventricle versus biventricular repair. Linear regression found that a higher parent education significantly predicted a lower total Psychosocial Assessment Tool score.Conclusions:Findings indicate that, although the majority of parents adapt to the acute stress of surgery for a serious cardiac illness in their infant, the remaining 38.5% report an increased psychosocial risk associated with higher rates of emotional distress, which may impact on the parental quality of life and capacity for optimal parenting. The distribution of psychosocial risk in parents of children undergoing surgery for a congenital heart disease is consistent with that described for parents of children with other serious paediatric diagnoses.

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