Subject(s)
Burns/psychology , Neoplasms/psychology , Parents/psychology , Resilience, Psychological , Sick Role , Stress Disorders, Post-Traumatic/psychology , Adaptation, Psychological , Adolescent , Anxiety, Separation/psychology , Child , Disability Evaluation , Disease Progression , Humans , Risk Factors , Stress Disorders, Post-Traumatic/diagnosisABSTRACT
BACKGROUND: To develop and validate a method of classifying the intensity of pediatric oncology treatments using four operationally defined categories of treatment intensity. PROCEDURE: An earlier version of a rating scale, the intensity of treatment rating (ITR), was revised and validated in two phases. In the Scale Construction phase, three criterion raters revised the ITR items based on consensus and item agreement data from pediatric oncologist raters (N = 15). In the Scale Validation phase, the new ITR-2 items were validated using a second set of pediatric oncologists external to our institution (N = 12). In addition, a third group of raters (N = 16), was employed to assess inter-rater reliabilities for 12 patients at varying levels of treatment intensities. RESULTS: Agreement between criterion ratings and the median of external raters for all 34 items on the ITR-2 was very high (r = 0.95, range 0.71-0.91). When the ITR-2 was used to rate 12 patient examples, the inter-rater agreement among pediatric oncologists was also very high (median agreement between criterion-rater pairs: r = 0.87; overall relatedness among 16 raters: r(ICC) = 0.83). CONCLUSIONS: The revised ITR Scale 2.0 (ITR-2) is a valid and reliable scale for classifying the intensity of pediatric oncology treatments.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/classification , Medical Oncology/methods , Neoplasms/therapy , Surveys and Questionnaires , Child , Combined Modality Therapy/adverse effects , Combined Modality Therapy/classification , Humans , Medical Oncology/standards , Neoplasm Staging , Neoplasms/diagnosis , Observer Variation , Recurrence , Reproducibility of Results , Risk FactorsABSTRACT
This study explored predictors of treatment response and attrition in Parent-Child Interaction Therapy (PCIT). Participants were 99 families of 3- to 6-year-old children with disruptive behavior disorders. Multiple logistic regression was used to identify those pretreatment child, family, and accessibility factors that were predictive of success or attrition. For all study participants, waitlist group assignment and maternal age were the significant predictors of outcome. For treatment participants (study participants excluding those who dropped out after the initial evaluation but before treatment began), only maternal ratings of parenting stress and maternal inappropriate behavior during parent-child interactions were significant predictors of treatment outcome. These results suggest that for treatment studies of disruptive preschoolers, the benefits of using a waitlist control group may be outweighed by the disproportionate number of dropouts from this group. Once families begin PCIT, however, parent-related variables become salient in predicting treatment outcome.
