Leiner Marie A, Balcazar Hector, Straus David C, Shirsat Pratibha, Handal Gilbert
Department of Pediatrics, Texas Tech University Health Sciences Center- El Paso, Texas, USA.
Rev Invest Clin. 2007 Mar-Apr;59(2):116-23.
Psychosocial and behavioral problems should be detected early during the pediatric consultation to prevent more severe psychosocial impairment as children move into adolescence. The pediatric visit offers an excellent opportunity to assess possible problems using screening tools. The aim of this study is to assess whether an adaptation of a screening tool (Pediatric Symptom Checklist) using visual aids is valid and suitable for the early detection of psychosocial problems among a sample of Mexican children and adolescents.
We included 411 of 468 (87.8%) Mexican mothers or female caretakers of children and adolescents aged 4-16 undergoing routine health assessments in two Preventive Child Health Clinical Services in El Paso, Texas, USA. Mothers or female caretakers completed the Pictorial Pediatric Symptom Checklist and a psychological comprehensive test known as the Child Behavior Checklist (CBCL). Sensitivity and specificity was established using the CBCL as criteria for the validity of the PPSC.
The PPSC screening tool performed well as demonstrated by its detection rates of psychosocial and behavioral problems among the sample of Mexican children. Sensitivity and specificity at the standard cut-off scores was 69.6% and 95.2% for children 4-5 years old and 61.8% and 91.8% for children 6-16 years old respectively. The results were slightly lower than those found using the PSC among other ethnic groups in the United States, with a sensitivity and specificity of 71.7% and 93.0%, respectively.
The PPSC is a simple, effective tool that can detect on average more than 65% of the children and adolescents with possible psychosocial problems during pediatric consultations. This free screening tool detected psychosocial problems in pediatric populations of Mexican origin living on the border and may be also effective for Mexican children living in Mexico.
在儿科问诊过程中应尽早发现心理社会和行为问题，以防止儿童进入青春期后出现更严重的心理社会损害。儿科就诊提供了一个使用筛查工具评估可能存在问题的绝佳机会。本研究的目的是评估使用视觉辅助工具对一种筛查工具（儿科症状清单）进行改编后，是否有效且适用于早期发现墨西哥儿童和青少年样本中的心理社会问题。
我们纳入了在美国得克萨斯州埃尔帕索市的两家儿童预防保健临床服务机构接受常规健康评估的468名4至16岁墨西哥儿童和青少年中的411名（87.8%）的母亲或女性监护人。母亲或女性监护人完成了图片版儿科症状清单以及一项名为儿童行为清单（CBCL）的心理综合测试。以CBCL作为PPSC有效性标准来确定敏感性和特异性。
PPSC筛查工具表现良好，墨西哥儿童样本中心理社会和行为问题的检出率证明了这一点。4至5岁儿童在标准临界分数下的敏感性和特异性分别为69.6%和95.2%，6至16岁儿童分别为61.8%和91.8%。结果略低于在美国其他种族群体中使用PSC时的结果，其敏感性和特异性分别为71.7%和93.0%。
PPSC是一种简单有效的工具，在儿科问诊期间平均能检测出超过65%可能存在心理社会问题的儿童和青少年。这种免费筛查工具在边境地区生活的墨西哥裔儿科人群中检测出了心理社会问题，并可能对生活在墨西哥的墨西哥儿童也有效。
