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患有癌症的儿童及其家庭提供心理社会服务，但通过系统的评估工具，可以准确识别正在进行的心理社会调整或困难的风险因素，这种护理可以得到加强，并提供更有效的服务。我们为新诊断患有癌症的儿童的家庭开发并进行了一项20项筛选工具——心理社会评估工具（PAT）的初步可行性试点研究。PAT包括基于研究文献和临床实践的10个风险领域的问题：家庭结构；家庭资源;社会支持;孩子的知识;学校;儿童情绪和行为问题；儿童年龄成熟度；婚姻/家庭问题;家庭的信念;和其他压力源。在本研究中，我们建议为PAT制定评分标准，并通过确定其心理测量特性（短期和6个月测试-重测信度以及并发效度、结构效度和预测效度）来评估它。在费城儿童医院（CHOP）招募了140个新诊断为癌症的儿童家庭，并要求他们完成PAT和问卷，评估父母、儿童和家庭在诊断时和6个月后的功能。还将从肿瘤学家和护士对家庭风险和功能的评分中获得数据。我们还将衡量医院资源的利用情况（例如，社会工作和心理干预，护理/医疗对社会心理问题的关注程度/强度，以及其他医院资源的使用情况）。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检验家长和工作人员对家庭风险的评估之间的联系，以及PAT的预测能力，以识别那些持续存在社会心理困难和资源利用水平较高的家庭。PAT是新颖的在其简短的经验方法来确定儿科肿瘤的家庭风险。通过在诊断时可靠地识别具有不同风险水平的家庭，我们可以在治疗过程中制定符合其需求水平的后续干预措施。

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.