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镰状细胞病的心理社会筛查:心理社会评估工具的验证。

Psychosocial Screening in Sickle Cell Disease: Validation of the Psychosocial Assessment Tool.

机构信息

Center for Healthcare Delivery Science, Nemours Children's Health System.

Sidney Kimmel Medical College, Thomas Jefferson University.

出版信息

J Pediatr Psychol. 2020 May 1;45(4):423-433. doi: 10.1093/jpepsy/jsaa002.

Abstract

OBJECTIVE

Families of youth with Sickle Cell Disease (SCD) can face psychosocial adversity including emotional distress, functional impairments, and sociodemographic risk factors. Systematic screening of psychosocial risk can identify families who may benefit from further assessment and evidence-based care. The Psychosocial Assessment Tool (PAT) is a brief caregiver-report screener based on the tri-level Pediatric Psychosocial Preventative Health Model (PPPHM).

METHODS

Findings are presented from the baseline assessment of a longitudinal study validating a Sickle Cell version of the PAT 2.0. Primary caregivers of 136 youth with SCD receiving care through a multidisciplinary SCD clinic in a children's hospital completed the PAT and validation measures. A subset of 25 caregivers completed the PAT a second time within 3-5 weeks.

RESULTS

Internal consistency for the total score was strong (α = .87), and for the subscales was moderate to strong (α  =  .74-.94), with the exception of the Family Structure (α  =  .38), Caregiver Beliefs (α  =  .48), and Stress Reactions (α  =  .56) subscales. Test-retest reliability was also strong (r = .86, p < .001). Moderate to strong correlations with all except two criteria measures provided validation for the total and subscale scores. Validation measures varied significantly across the three levels of the PPPHM.

CONCLUSIONS

Results provide support for the reliability and validity of the PAT in SCD. Systematic screening with the PAT can help identify families of youth with SCD at risk for psychosocial problems and potentially help connect them to appropriate services.

摘要

目的

镰状细胞病(SCD)患儿的家庭可能面临心理社会逆境,包括情绪困扰、功能障碍和社会人口学风险因素。系统筛查心理社会风险可以识别出可能受益于进一步评估和循证护理的家庭。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)的简短照顾者报告筛查工具。

方法

本研究介绍了验证 PAT 2.0 镰状细胞版本的纵向研究的基线评估结果。在一家儿童医院的多学科 SCD 诊所接受治疗的 136 名 SCD 患儿的主要照顾者完成了 PAT 和验证措施。其中 25 名照顾者在 3-5 周内完成了 PAT 的第二次测试。

结果

总分的内部一致性很强(α=.87),分量表的一致性为中等至很强(α=.74-.94),除家庭结构(α=.38)、照顾者信念(α=.48)和应激反应(α=.56)分量表外。测试重测信度也很强(r =.86,p <.001)。与所有除两项标准测量之外的测量都有中等至强的相关性,为总分和分量表得分提供了验证。验证测量在 PPPHM 的三个水平上有显著差异。

结论

结果支持 PAT 在 SCD 中的可靠性和有效性。使用 PAT 进行系统筛查可以帮助识别出 SCD 患儿家庭面临心理社会问题的风险,并可能帮助他们获得适当的服务。

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