Journal of Clinical Oncology, Vol 21, Issue 17
(September), 2003: 3220-3225
© 2003 American Society for Clinical Oncology
Identifying Psychosocial Risk Indicative of Subsequent Resource Use in Families of Newly Diagnosed Pediatric Oncology Patients
Anne E. Kazak,
M. Catherine Cant,
Merritt M. Jensen,
Mary McSherry,
Mary T. Rourke,
Wei-Ting Hwang,
Melissa A. Alderfer,
David Beele,
Steven Simms,
Beverly J. Lange
From the Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA.
Address reprint requests to Anne E. Kazak, PhD, ABPP, Division of Oncology, The Children’s Hospital of Philadelphia, Room 1486 CHOP North, 34th St and Civic Center Blvd, Philadelphia, PA 19104; email: kazak{at}e-mail.chop.edu.
Purpose: The primary purpose of this prospective study was to identify the level of risk for psychosocial distress in families of children newly diagnosed with cancer. Additional study aims were to examine concordance among family and staff reports of psychosocial risk, changes in risk status over time, and to predict the use of psychosocial resources during the first months of treatment.
Patients and Methods: Caregivers of 125 children newly diagnosed with cancer completed the Psychosocial Assessment Tool (PAT) at diagnosis (t1) and 3 to 6 months later (t2). Primary oncologists and nurses completed an analogous measure of perceived family psychosocial risk at t1 and t2. At t2, oncology social workers reported types and intensity of psychosocial interventions provided.
Results: The PAT identified three subsets of families who presented with increasing levels of psychosocial risk at diagnosis. In general, there was moderate concordance among family, oncologist, and nurse reports of psychosocial risk. PAT scores at t1 predicted t2 PAT scores and psychosocial resource use at t2 beyond demographic or disease factors.
Conclusion: A brief screening tool (PAT) is valuable in identifying psychosocial risk factors at diagnosis and is predictive of later use of psychosocial resources. As a next step in this research, the development of psychosocial interventions to match family risk level may be an effective and cost-efficient approach to working with families to address their concerns and promote short- and long-term adjustment.
Supported by the University of Pennsylvania Cancer Center and the United States Child and Maternal Health Bureau Leadership Education in Neurodevelopmental Disabilities Training Grant at The Children’s Hospital of Philadelphia.
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