Nemours Children's Health System.
Sidney Kimmel Medical School, Thomas Jefferson University.
J Pediatr Psychol. 2018 Aug 1;43(7):737-748. doi: 10.1093/jpepsy/jsy012.
Family psychosocial risk screening is an important initial step in delivering evidence-based care. The Psychosocial Assessment Tool (PAT) is a brief parent report screener based on the trilevel Pediatric Psychosocial Preventative Health Model (PPPHM; Universal, Targeted, Clinical). The current article validates a revised PAT (version 3.0) in pediatric oncology that includes new items (for families of younger patients; clinically relevant risk items) and applicable to broad health literacy levels (a 4th grade reading level).
Primary caregivers of 394 children newly diagnosed with cancer participated in this multisite investigation, completing the PAT and validation measures using REDCap.
The original structure of the PAT, with seven subscales (Family Structure, Social Support, Child Problems, Sibling Problems, Family Problems, Stress Reactions, and Family Beliefs) was supported using a confirmatory factor analysis. Internal consistency for the total score (Kuder-Richardson 20 coefficient [KR20] = 0.81) and the subscales (KR20 = 0.59-0.85) was moderate to strong. Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. The validation measures varied significantly, as expected, across the three levels of the PPPHM. Receiver operating characteristic (ROC) analyses showed that the PAT total and subscale scores can discriminate families above and below clinical thresholds.
Results reinforce the psychometric properties of this approach for screening of family psychosocial risk. The PAT provides an evidence-based screener that identifies families at three levels of risk and can provide the basis for further evaluation and treatment of children with cancer and their families.
家庭心理社会风险筛查是提供循证护理的重要初始步骤。心理社会评估工具（PAT）是一种基于三层次儿科心理社会预防保健模型（PPPHM；普遍、靶向、临床）的简短家长报告筛查工具。本文验证了一种新的儿科肿瘤学修订版 PAT（第 3.0 版），其中包括新的项目（适用于年龄较小的患者的家庭；临床相关风险项目）和适用于广泛健康素养水平的项目（四年级阅读水平）。
394 名新诊断为癌症的儿童的主要照顾者参与了这项多地点研究，他们使用 REDCap 完成了 PAT 和验证措施。
使用验证性因子分析支持 PAT 的原始结构，该结构有七个分量表（家庭结构、社会支持、儿童问题、兄弟姐妹问题、家庭问题、应激反应和家庭信念）。总分（Kuder-Richardson 20 系数[KR20] = 0.81）和分量表（KR20 = 0.59-0.85）的内部一致性为中等至较强。与标准测量的中度至强相关性为总分和分量表得分提供了验证。验证措施在 PPPHM 的三个层次上有显著差异。接收者操作特征（ROC）分析表明，PAT 总分和分量表得分可区分高于和低于临床阈值的家庭。
结果加强了这种方法用于筛查家庭心理社会风险的心理测量特性。PAT 提供了一种基于证据的筛查工具，可识别处于三个风险水平的家庭，并可为进一步评估和治疗癌症儿童及其家庭提供基础。
