Murphy J M, Ichinose C, Hicks R C, Kingdon D, Crist-Whitzel J, Jordan P, Feldman G, Jellinek M S
Child Psychiatry, Service, Massachusetts General Hospital, Boston 02114, USA.
J Pediatr. 1996 Dec;129(6):864-9. doi: 10.1016/s0022-3476(96)70030-6.
To examine the usefulness of the Pediatric Symptom Checklist (PSC) as the psychosocial screening measure to meet federal Medicaid/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) standards in a low-income Hispanic community.
Three hundred seventy-nine children (aged 6 to 16 years) were screened with the PSC in a 10-month period during well child visits to three clinics in Ventura and San Mateo counties in California. The PSC was available in English and Spanish and was administered both in written (paper-and-pencil) and oral formats. Follow-up services were provided for children identified as needing evaluation.
The Cronbach alpha was high (r = 0.91) for the PSC in the whole sample and virtually identical for English, Spanish, oral, and written formats. All the PSC items were significantly associated with total score on the PSC in English, Spanish, oral, and written formats. Overall, the PSC identified 10.6% of the sample as at risk for psychosocial problems. Thirty-six children (9.5% of sample) were referred for mental health follow-up. Public health data from Ventura County showed a statistically significant increase in referrals for psychologic problems during the study period in two locations using the PSC: from 0.5% to 2.9% of the school-aged children seen.
The PSC provides a feasible, well-accepted method for screening for psychosocial problems during EPSDT examinations of school-aged children. Psychosocial screening using a validated instrument such as the PSC, as well as increased efforts to refer positive screening results, track outcomes, and assess cost benefits should be essential requirements in capitated Medicaid approaches to caring for poor children.
探讨儿童症状清单（PSC）作为一种心理社会筛查工具，在低收入西班牙裔社区中满足联邦医疗补助/早期定期筛查、诊断和治疗（EPSDT）标准的有用性。
在加利福尼亚州文图拉县和圣马特奥县的三家诊所进行的为期10个月的健康儿童检查期间，使用PSC对379名6至16岁的儿童进行了筛查。PSC有英文和西班牙文版本，以书面（纸笔）和口头两种形式进行施测。为被确定需要评估的儿童提供了后续服务。
整个样本中PSC的克朗巴哈系数较高（r = 0.91），英文、西班牙文、口头和书面形式的系数几乎相同。所有PSC项目在英文、西班牙文、口头和书面形式中均与PSC总分显著相关。总体而言，PSC确定10.6%的样本存在心理社会问题风险。36名儿童（占样本的9.5%）被转介进行心理健康随访。文图拉县的公共卫生数据显示，在研究期间，使用PSC的两个地点因心理问题转介的儿童数量有统计学显著增加：从接受检查的学龄儿童的0.5%增至2.9%。
PSC为学龄儿童EPSDT检查期间的心理社会问题筛查提供了一种可行且被广泛接受的方法。在按人头付费的医疗补助模式下照顾贫困儿童时，使用经过验证的工具（如PSC）进行心理社会筛查，以及加大对筛查结果呈阳性的儿童进行转介、跟踪结果和评估成本效益的力度，应成为基本要求。
