Etkin-Spigelman Laurel, Hancock Kelly, Nathan Paul C, Barrera Maru
The Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Blood Cancer. 2022 Feb;69(2):e29456. doi: 10.1002/pbc.29456. Epub 2021 Dec 2.
Psychosocial morbidity in pediatric oncology patients and their caregivers is widely recognized. Although routine systematic psychosocial screening has been proposed as a standard of care, screening is still limited. The present study assessed whether supplying the patient's treating team of healthcare providers with psychosocial risk screening information near diagnosis would increase the rate of documented psychosocial contacts, particularly for patients/families with elevated risk. The effect of demographic and clinical factors was also examined.
Ninety-three families with a child/youth newly diagnosed with cancer participated. Families were randomly assigned to a care as usual control group (n = 44) or an intervention group (n = 49) where the treating team was provided with a summary of family psychosocial risk, measured by the Psychosocial Assessment Tool (PAT). The PAT was completed by the primary caregiver, who also provided demographic information. The number of psychosocial intervention contacts documented in the medical charts was examined.
The rate of psychosocial intervention did not significantly differ between the groups (P > 0.05). The intensity of the child's cancer treatment was found to be the only significant predictor of the number of documented psychosocial intervention contacts (β = 0.396, P < 0.001).
Clinical factors appear to be more predictive of the rate of psychosocial intervention provided to pediatric oncology patients and their families than informing the treating team of family psychosocial risk. Additional research is required to address the gap between psychosocial risk screening, psychosocial intervention, and family outcomes.
儿科肿瘤患者及其照顾者的心理社会疾病已得到广泛认可。尽管常规系统的心理社会筛查已被提议作为一种护理标准，但筛查仍然有限。本研究评估了在诊断时向患者的医疗服务提供团队提供心理社会风险筛查信息是否会提高记录在案的心理社会接触率，特别是对于风险较高的患者/家庭。还研究了人口统计学和临床因素的影响。
93个有新诊断癌症儿童/青少年的家庭参与了研究。这些家庭被随机分配到常规护理对照组（n = 44）或干预组（n = 49），在干预组中，治疗团队会收到通过心理社会评估工具（PAT）测量的家庭心理社会风险总结。PAT由主要照顾者完成，其还提供了人口统计学信息。检查了病历中记录的心理社会干预接触次数。
两组之间的心理社会干预率没有显著差异（P > 0.05）。发现儿童癌症治疗的强度是记录在案的心理社会干预接触次数的唯一显著预测因素（β = 0.396，P < 0.001）。
与向治疗团队告知家庭心理社会风险相比，临床因素似乎更能预测向儿科肿瘤患者及其家庭提供心理社会干预的比率。需要进一步研究来解决心理社会风险筛查、心理社会干预和家庭结局之间的差距。
