Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada.
Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada; Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
J Pain Symptom Manage. 2018 Jul;56(1):107-112. doi: 10.1016/j.jpainsymman.2018.03.025. Epub 2018 Apr 6.
Primary objectives were to evaluate the interrater reliability and validity of proxy-report Symptom Screening in Pediatrics Tool (SSPedi) in children with cancer and pediatric hematopoietic stem cell transplant (HSCT) recipients. Secondary objective was to describe the interrater reliability of each SSPedi item.
Respondents were children aged eight to 18 years with cancer or HSCT recipients, and their parents or guardians. We enrolled two pediatric respondent groups. The more symptomatic group was receiving active treatment for cancer, admitted to hospital, and expected to be in a hospital three days later. The less symptomatic group either was in maintenance therapy for acute lymphoblastic leukemia or had completed cancer treatments. Convergent validity was evaluated by comparing proxy-reported mucositis, nausea and vomiting, pain, and total SSPedi scores, with child self-reported validated scales, and we hypothesized fair correlations. Discriminant validity was evaluated by comparing proxy-reported total SSPedi scores between groups. Interrater reliability of each SSPedi item was evaluated.
Four hundred thirty-nine child and parent or guardian pairs were recruited. Mean difference in proxy-reported SSPedi scores between the more and less symptomatic groups was 8.2, 95% CI 6.6-9.8. All hypothesized relationships among measures were observed. Intraclass correlation coefficients for SSPedi items ranged from 0.34 (problems with thinking) to 0.80 (diarrhea).
Proxy-report SSPedi is reliable and valid in children aged 8 years to 18 years with cancer and HSCT recipients. Future work should support proxy-reported symptom assessment in clinical settings where children are not able to self-report or communicate bothersome symptoms.
主要目的是评估代理报告儿科症状筛查工具（SSPedi）在癌症儿童和儿科造血干细胞移植（HSCT）受者中的评分者间信度和效度。次要目的是描述每个 SSPedi 项目的评分者间信度。
受访者为 8 至 18 岁的癌症或 HSCT 患儿及其父母或监护人。我们纳入了两个儿科受访者群体。症状更明显的群体正在接受癌症的积极治疗，住院，并预计 3 天后住院。症状较轻的群体正在接受急性淋巴细胞白血病的维持治疗，或已完成癌症治疗。通过将代理报告的黏膜炎、恶心和呕吐、疼痛和 SSPedi 总分与儿童自我报告的验证量表进行比较，评估了聚合效度，并假设存在适度的相关性。通过比较两组之间代理报告的 SSPedi 总分，评估了区分效度。评估了每个 SSPedi 项目的评分者间信度。
共招募了 439 对儿童和父母或监护人。症状更明显组和症状较轻组的代理报告 SSPedi 评分差异平均值为 8.2，95%CI 为 6.6-9.8。所有假设的测量之间的关系都得到了观察。SSPedi 项目的组内相关系数范围从 0.34（思维问题）到 0.80（腹泻）。
代理报告的 SSPedi 在 8 至 18 岁的癌症和 HSCT 受者中具有可靠性和有效性。未来的研究应支持在儿童无法自我报告或无法交流不适症状的临床环境中使用代理报告的症状评估。
