Distress screening, rater agreement, and services in pediatric oncology
Distress screening, rater agreement, and services in pediatric oncology
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DOI：
10.1002/pon.1859
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发表时间：
2011-12-01
期刊：
影响因子：
3.6
通讯作者：
Sato, Judith K.
中科院分区：
文献类型：
--
作者：
Patel, Sunita K.;Mullins, Wendy;Sato, Judith K.
目的：基于经验的数据支持国家综合癌症网络推荐的痛苦体温计作为患者痛苦的标准筛查的有效性。然而，危难体温计在儿科肿瘤学环境中的可行性和实用性尚未得到研究。我们进行了一项研究：(1)调查调整后的痛苦温度计在儿童肿瘤患者中的有效性；(2)评估不同受访者(包括医生和心理社会工作人员)关于(A)儿科癌症患者的痛苦和(B)照顾者/父母的痛苦的一致性程度，以及(3)评估痛苦程度与为患者及其家人提供的心理社会服务之间的关系。方法：对91名患者及其英语和西班牙语照顾者进行前瞻性评估，每隔3个月评估一次，为期1年。对每个家庭提供的心理社会服务的数量进行了12个月的记录。结果：儿童痛苦评估工具与标准化测量工具之间具有合理的一致性，证明了收敛的效度。此外，使用更广泛的评估，人口统计学和医学预测痛苦的因素与之前报道的结果一致。儿童痛苦的多个评分者之间有合理的一致性；然而，在照顾者痛苦的自我评分和心理社会工作人员对照顾者痛苦的评分之间存在差异。这种认知上的差异影响了基线评估后提供的心理社会服务的质量。结论：单项痛苦体温计是一种可行的选择，作为患者和照顾者痛苦的快速筛查工具，有助于有效地确定哪些人应该接受进一步的评估。版权所有(C)2010 John Wiley&Sons，Ltd.
Objective: Empirically based data support the validity of the distress thermometer recommended by the National Comprehensive Cancer Network as a standard screen for patient distress. However, the feasibility and utility of the distress thermometer has not been studied in the pediatric oncology setting. We conducted a study to: (1) investigate the validity of an adapted distress thermometer with pediatric oncology patients, (2) assess the degree of agreement among different respondents, including physician and psychosocial staff, with respect to (a) the pediatric cancer patient's distress and (b) the caregiver/parent's distress, and (3) to evaluate the relationship between distress levels and the psychosocial services provided to patients and families.Methods: Ninety-one patients and their English and Spanish-speaking caregivers were prospectively assessed at 3-month intervals for 1 year. The quantity of psychosocial services provided to each family was logged for a 12-month period.Results: Convergent validity was demonstrated by reasonable agreement between the pediatric distress rating tool and standardized measures. Additionally, the demographic and medical predictors of distress were consistent with previously reported findings using more extensive assessment. There was reasonable agreement among multiple raters of the child's distress; however, there was discrepancy between self-ratings of caregiver distress and psychosocial staff ratings of caregiver distress. This difference in perception impacted the quantity of psychosocial services provided following the baseline assessment.Conclusion: The single-item distress thermometer is a viable option as a rapid screening tool of patient and caregiver distress to help efficiently identify those who should be evaluated further. Copyright (C) 2010 John Wiley & Sons, Ltd.