Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool

Abstract

Family psychosocial risk screening is an important initial step in delivering evidence-based care in hematopoietic stem cell transplantation (HCT). Establishing an evidence-based screening approach that is acceptable, reliable, and valid is an essential step in psychosocial care delivery. This is a 3-institution multimethod study. In part 1, caregivers of children about to undergo HCT (n = 140) completed the Psychosocial Assessment ToolÀHematopoietic Cell Transplantation (PAT-HCT), a brief parent report screener adapted for HCT, and validating questionnaires. Families received feedback on their risks identified on the PAT-HCT. In part 2, 12 caregivers completed a semistructured interview about their perceptions of the PAT and the feedback process. The reliability and validity of the PAT-HCT total and subscale scores were tested using Kuder-Richardson-20 (KR-20) and Pearson correlations. Thematic content analysis was used to analyze the qualitative interview data. Internal consistency for the total score (KR-20 = .88) and the Child Problems, Sibling Problems, Family Problems, and Stress Reactions subscales were strong (KR-20 >.70). Family Structure, Social Support, and Family Beliefs subscales were adequate (KR-20 = .55 to .63). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Feedback was provided to 97.14% of the families who completed the PAT-HCT, and the mean rating of acceptability was >4.00 (on a 5-point scale). The qualitative data indicate that families appreciate the effort to provide screening and feedback. The PAT-HCT is a psychometrically sound screener for use in HCT. Feedback can be given to families. Both the screener and the feedback process are acceptable to caregivers.

A psychosocial clinical care pathway for pediatric hematopoietic stem cell transplantation

“…It began with a presentation on psychosocial care delivery (AK) describing the type of clinicians providing psychosocial care and its structure (e.g., integrated vs consultation models). Participants also learned about the purpose and results of the prior studies and the four themes were presented. All questions posed to the group were open‐ended.…”

“…Currently, psychosocial care in HCT is not driven by clearly articulated or tested models nor are evaluations and subsequent treatment approaches regularly used . In this paper, we propose a psychosocial clinical care pathway (PCCP) that is informed by and derived from our mixed methods research with HCT caregivers and providers . The PCCP is a multidisciplinary approach that standardizes services provided for a group of patients with a sequence of well‐defined steps.…”

“…This paper is the third of three in this program of research. The first study was a quantitative psychometric validation of an HCT adaptation of the PAT . The second study was a qualitative investigation of how screening could inform clinical care .…”

“…The proposed PCCP begins with administration of the HCT version of the Psychosocial Assessment Tool (PAT‐HCT), a brief parent report screener of psychosocial risks, recently validated for this population . The PAT‐HCT assesses risks across eight social ecological areas of importance to family functioning—family structure, social support, child problems, sibling problems, family problems, stress reactions, family beliefs, and other.…”

Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): Study protocol for a cluster randomized comparative effectiveness trial

“…8,9, 11, 29,17 ,16, 29 We showed that PAT can be completed at diagnosis 17 and it has been shown to impact psychosocial outcomes for mothers at higher levels of distress when results are shared with staff. 30 Our group has adapted the PAT for use in hematopoietic stem cell transplantation (HCST) 31 including development of a clinical pathway, guided by stakeholder input, that could facilitate its integration in clinical care. 32,33 We have also adapted the PAT for use in Sickle Cell Disease, adding items to capture relevant aspects of the social context for families (e.g., school absences, changes in housing).…”