A family psychosocial risk questionnaire for use in pediatric practice.
A family psychosocial risk questionnaire for use in pediatric practice.
复制标题
用于儿科实践的家庭心理社会风险问卷。
DOI：
10.1007/s10995-012-1208-3
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发表时间：
2013
影响因子：
2.3
通讯作者：
Forrest,ChristopherB
中科院分区：
文献类型：
--
作者：
Pati,Susmita;Guevara,James;Zhang,Guangxiang;Bhatt,SurajK;Kavanagh,Jane;Gerdes,Marsha;Localio,Russell;Forrest,ChristopherB
这项研究的目的是开发新的方法，以更好地识别心理社会风险，使儿童与未来的结果不佳的风险最大，得到更密集的预防性卫生服务。基于结构化文献回顾和二级数据分析，对2，083个儿童（<36个月）家庭进行了52项心理社会风险问卷调查。为了量化问卷的结构效度，使用年龄和阶段问卷第二版（ASQ）[n = 1，163]评估发展关注。迭代模型选择过程用于产生最简约的预测模型。使用c-统计量、Hosmer-Lemeshow检验和基于拟合对数似然值和相关自由度的模型过拟合的启发式测量来检查模型拟合。我们发现13个项目很容易从父母的报告产生了回归模型的c-统计量为0.70。使用从回归模型中得出的整数评分系统，我们计算了特定层的似然比，以修正ASQ失败的给定先验概率。对于问卷中最高风险组（得分>25）的儿童，ASQ失败的后验概率为44.9%，是我们观察到的平均失败率19.5%的两倍多，而对于问卷中得分最低的儿童，ASQ失败的后验概率不到7%。十三个家长报告的项目可以被编译成一个总结的心理社会风险问卷，预测失败的学龄前儿童的发展筛选。随着进一步的验证，这份问卷可以想象的是，临床医生使用量身定制的儿科预防保健，以儿童在不同程度的风险。
The objective of this study is to develop new methods to better identify psychosocial risk such that children with the greatest risk of poor future outcomes receive more intensive preventive health services. Based on structured literature review and secondary data analysis, a 52-item psychosocial risk questionnaire was administered to 2,083 families of children (<36 months). To quantify the questionnaire’s construct validity, developmental concern was assessed with the Ages and Stages Questionnaire version II (ASQ) [n = 1,163]. An iterative model selection process was used to produce the most parsimonious predictive model. Model fit was examined using c-statistics, the Hosmer–Lemeshow test, and a heuristic measure of model overfit based on the fitted log-likelihood values and associated number of degrees of freedom. We found 13 items easily obtained from parental report produced a regression model with a c-statistic of 0.70. Using an integer scoring system derived from the regression model, we calculated stratum specific likelihood ratios to revise a given prior probability of ASQ failure. The posterior probability of ASQ failure was 44.9 % for a child in the highest risk group (score >25) on the questionnaire, more than double our observed average failure rate of 19.5 %, while it was less than 7 % for a child with the lowest possible score on the questionnaire. Thirteen parent-reported items can be compiled into a summary psychosocial risk questionnaire that predicts failure on developmental screening among preschool children. With further validation, this questionnaire could conceivably be used by clinicians to tailor pediatric preventive care to children at varying levels of risk.