Psychosocial Assessment Tool:Risk Factors for Distress

描述(由申请人提供)：虽然大多数癌症治疗中心都为癌症儿童及其家人提供心理社会服务，但这种护理可能会得到加强，并通过系统的评估工具提供更有效的服务，这些工具可以准确地识别持续心理社会调整或困难的风险因素。我们已经开发并进行了一项20项筛查工具--心理社会评估工具(PAT)的初步可行性初步研究，该工具适用于新诊断为癌症的儿童家庭。PAT基于研究文献和临床实践，包括对L 0个风险领域的问题：家庭结构；家庭资源；社会支持；儿童知识；学校；儿童情感和行为关注；儿童年龄成熟度；婚姻/家庭问题；家庭信仰；以及其他压力源。在本研究中，我们建议制定PAT的评分标准，并通过确定其心理测量学特性(短期和6个月重测信度以及同时效度、结构效度和预测效度)对其进行评估。费城儿童医院(CHOP)将招募140个新诊断为癌症儿童的家庭，并要求他们完成PAT和问卷，评估诊断时和6个月后父母、儿童和家庭的功能。数据还将从肿瘤学家和护士那里获得家庭风险和功能的评级。我们也会衡量医院资源的使用情况(例如社会工作和心理干预、护理/医疗对心理社会问题的关注程度/强度，以及其他医院资源的使用情况)。一个由儿科肿瘤学多学科专家组成的外部小组将协助确定项目的评分和权重。我们的假设和相关的统计分析将测试家长和工作人员对家庭风险的评估与PAT的预测能力之间的关系，以识别那些持续存在心理社会困难和资源利用水平上升的家庭。PAT在确定儿科肿瘤学中的家庭风险方面具有新颖性。通过可靠地识别诊断时具有不同风险水平的家庭，我们可以制定后续干预措施，以满足他们在治疗过程中的需求水平。

DESCRIPTION (provided by applicant): While psychosocial services for children with cancer and their families are available in most cancer treatment centers, this care may be enhanced and delivered with greater effectiveness with systematic assessment instruments that can accurately identify risk factors for ongoing psychosocial adjustment or difficulties. We have developed and conducted a preliminary feasibility pilot study of a 20 item screening instrument, the Psychosocial Assessment Tool (PAT) for families of children newly diagnosed with cancer. The PAT includes questions for l 0 domains of risk, based on the research literature and clinical practice: Family Structure; Family Resources; Social Support; Child Knowledge; School; Child Emotional and Behavioral Concerns; Child Maturity for Age; Marital/Family Problems; Family Beliefs; and Other Stressors. In the present study we propose to develop scoring criteria for the PAT and to evaluate it by determining its psychometric properties (short-term and 6 month test-retest reliability and concurrent, construct, and predictive validity). 140 families of children newly diagnosed with cancer at The Children's Hospital of Philadelphia (CHOP) will be recruited and asked to complete the PAT and questionnaires assessing parental, child and family functioning at diagnosis and 6 months subsequently. Data will also be obtained from oncologist and nurse ratings of family risk and function. We will also measure hospital resource utilization (e.g., social work and psychological interventions, extent/intensity of nursing/medical attention to psychosocial issues, and use of other hospital resources). An external panel of multidisciplinary experts in pediatric oncology will assist in determining the scoring and weighting of items. Our hypotheses and related statistical analyses will test associations among parent and staff assessments of family risk and the predictive ability of the PAT to identify those families with ongoing psychosocial difficulty and elevated levels of resource utilization. The PAT is novel in its brief empirical approach to determining family risk in pediatric oncology. By reliably identifying families with varying levels of risk at diagnosis we may develop subsequent interventions which match their level of need over the course of treatment.