The association of psychosocial screening and service provision in pediatric oncology: the Psychosocial Assessment Tool (PAT2.0) into clinical practice
- 262 Downloads
Distress screening in oncology has been widely endorsed in recent years. However, current knowledge of the impact of screening on delivery of clinical psychosocial services is limited. This study investigated the association between screening and psychosocial services in the early period following diagnosis of childhood cancer.
The Psychosocial Assessment Tool (PAT2.0) was administered by clinical social workers in two pediatric oncology centers shortly following diagnosis. Psychosocial service activity in the first 8 weeks post diagnosis was collected via social work surveys and extraction of information from hospital databases.
PAT2.0 and psychosocial service data were obtained for 89 families with a child newly diagnosed with cancer. Distribution of PAT2.0 risk categories was consistent with previous studies (57.3 % universal, 38.2 % targeted, 4.5 % clinical). Significant, weak to moderate correlations between PAT2.0 and social workers’ estimates of psychosocial risk were observed. No significant differences in the amount of psychosocial services provided to families with “universal” versus “elevated” (i.e., targeted or clinical) risk were found. Number of days in hospital was strongly and positively associated with the amount of psychosocial services families received in the first 8 weeks following diagnosis.
Psychosocial risk, as measured by the PAT2.0, and allocation of psychosocial services were not significantly associated in the early period following diagnosis. Further investigation is required to understand if differences emerge over time when psychosocial screening is implemented clinically. Development of clinical pathways of care needs to account for patients who may predominantly be treated in the outpatient setting.
KeywordsScreening Pediatric oncology Distress Psychosocial Childhood cancer
This study was funded by the Victorian Cancer Agency (Supportive Care Capacity Building Grant SCB11_09), The Ponting Foundation, and the Victorian Government Department of Human Services and Operational Infrastructure Support Program. Maria McCarthy is supported by an MCRI Career Development Award. Claire Wakefield is supported by a Career Development Fellowship from the National Health and Medical Research Council of Australia (APP1067501) and an Early Career Development Fellowship from the Cancer Institute of NSW (ID 11/ECF/3-43). The Behavioral Sciences Unit is supported by the Kids with Cancer Foundation. We gratefully acknowledge the families and the health care providers, particularly the social workers, who were so generous in their participation in this study.
Compliance with ethical standards
This research involved human participants and was approved by The Royal Children’s Hospital Human Research Ethics Committee (ref. no. 31230A) and the Monash Children’s Human Research Ethics Committee (ref. no. 12070X). All participants provided written consent to participate in the study.
The authors have no conflicts of interest to declare including no financial relationships with any organizations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work.
Conflict of interest
The authors have no conflict of interest to declare. The authors have full control of the data and agree to share this with the journal if requested.
- 2.Lazenby M (2014) The international endorsement of US distress screening and psychosocial Guidelines in oncology: a model for dissemination. J Natl Compr Cancer Netw 221–227Google Scholar
- 5.Comission for Cancer (2012) Cancer program standards 2012: ensuring patient centred care, V1.0. American College of Surgeons, ChicagoGoogle Scholar
- 7.Pai AL, Patino-Fernandez AM, McSherry M, Beele D, Alderfer MA, Reilly AT, Hwang WT, Kazak AE (2008) The Psychosocial Assessment Tool (PAT2.0): psychometric properties of a screener for psychosocial distress in families of children newly diagnosed with cancer. J Pediatr Psychol 33(1):50–62. doi: 10.1093/jpepsy/jsm053
- 11.Barrera M, Hancock K, Rokeach A, Cataudella D, Atenafu E, Johnston D, Punnett A, Nathan PC, Bartels U, Silva M, Cassidy M, Jansen P, Shama W, Greenberg C (2014) External validity and reliability of the Psychosocial Assessment Tool (PAT) among Canadian parents of children newly diagnosed with cancer. Pediatr Blood Cancer 61(1):165–170. doi: 10.1002/pbc.24774 CrossRefPubMedGoogle Scholar
- 12.Alderfer MA, Mougianis I, Barakat LP, Beele D, DiTaranto S, Hwang WT, Reilly AT, Kazak AE (2009) Family psychosocial risk, distress, and service utilization in pediatric cancer: predictive validity of the Psychosocial Assessment Tool. Cancer 115(18 Suppl):4339–4349. doi: 10.1002/cncr.24587 CrossRefPubMedGoogle Scholar
- 14.Barrera M, Hancock K, Rokeach A, Atenafu E, Cataudella D, Punnett A, Johnston D, Cassidy M, Zelcer S, Silva M, Jansen P, Bartels U, Nathan P, Greenbery C (2014) Does the use of the revised Psychosocial Assessment Tool (PATrev) result in improved quality of life and reduced psychosocial risk in Canadian families with a child newly diagnosed with cancer? Psycho-Oncology 23(2):165–172. doi: 10.1002/pon.3386 CrossRefPubMedGoogle Scholar
- 18.Pai AL, Tackett A, Hente E, Ernest M, Denson L, Hommel K (2014) Assessing psychosocial risk in pediatric inflammatory bowel disease: validation of the Psychosocial Assessment Tool 2.0_general. J Pediatr Gastroentrerol Nutr 58(1):51–56. doi: 10.1097/MPG.0b013e3182a938b7