Family psychosocial risk, distress, and service utilization in pediatric cancer: predictive validity of the Psychosocial Assessment Tool.

BACKGROUND: The way families negotiate diagnosis and early treatment for pediatric cancer sets the stage for their adaptation throughout treatment and survivorship. The Psychosocial Assessment Tool (PAT) is a brief parent-report screener capable of systematically identifying families at risk for problems of adaptation. The current study evaluated stability and predictive validity of PAT psychosocial risk classification with regard to distress, family functioning, and the use of psychosocial services over the first 4 months of treatment. METHODS: Caregivers of children with cancer completed the PAT and measures of distress and family functioning at diagnosis and again 4 months into treatment. At the second time point, social workers completed checklists of services provided and rated the intensity of their work with each family. Referrals to psychologists also were tracked. RESULTS: Psychosocial risk classification, based on the PAT, was stable across the first 4 months of cancer treatment; 57% to 69% of families remained at the same level of risk. PAT total scores did not differ across time, but subscale scores indicated increases in family and child (patient) problems and decreases in unhelpful beliefs. Families classified at higher levels of psychosocial risk at diagnosis had more distress, more family problems, and greater psychosocial service use 4 months into treatment. CONCLUSIONS: Understanding and identifying risks for psychosocial adjustment difficulties within families of children with cancer, considering changes across treatment and beyond, is very complex. Despite evidence of the predictive validity of PAT, additional research is necessary to find ways to effectively use this screener in practice to guide intervention.

The Psychosocial Assessment Tool (PAT2.0): psychometric properties of a screener for psychosocial distress in families of children newly diagnosed with cancer.

UNLABELLED: Purpose Psychometric properties of the Psychosocial Assessment Tool 2.0 (PAT2.0), a brief screener for psychosocial risk in families of children with cancer, are presented. METHODS: Female (N = 132) and male (N = 72) caregivers of 141 children newly diagnosed with cancer completed the PAT2.0 and measures of child behavior symptoms, anxiety, acute stress, and family functioning to establish validity. Internal consistency and test-retest reliability of the PAT2.0 were also examined. RESULTS: Internal consistency and two-week test-retest for the PAT2.0 Total score was strong. Validity for the PAT2.0 was supported by significant correlations between the PAT2.0 subscales and measures of corresponding constructs. PAT2.0 Total scores were correlated with acute stress and child behavior symptoms for both mothers and fathers. Receiver-Operating Characteristic curves provided preliminary support for the proposed cutoffs. CONCLUSION: The PAT2.0 Total score is a useful screening tool for family psychosocial risk in the pediatric oncology population.