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Screening for psychosocial risk at pediatric cancer diagnosis: the psychosocial assessment tool
Anne E Kazak1, Lamia P Barakat, Susan Ditaranto
1Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. kazak@email.chop.edu
Insights
Integrating the Psychosocial Assessment Tool (PAT) into pediatric cancer care is feasible. This evidence-based screening tool improves psychosocial risk documentation in medical records, with most families reporting low risk.
Area of Science:
- Pediatric Oncology
- Psychosocial Health
- Healthcare Integration
Background:
- Pediatric cancer diagnosis presents significant psychosocial challenges for families.
- Current psychosocial care integration in pediatric oncology may be suboptimal.
- Need for standardized, evidence-based screening tools at diagnosis.
Purpose of the Study:
- To assess the feasibility of implementing the Psychosocial Assessment Tool (PAT) in pediatric oncology.
- To evaluate the PAT's effectiveness in identifying and documenting psychosocial risks.
- To compare risk documentation between PAT and usual care.
Main Methods:
- A prospective study comparing the PAT with psychosocial care as usual (PAU).
- Parents of newly diagnosed pediatric cancer patients were assigned to PAT or PAU groups.
- Key metrics included PAT completion time, result communication, risk score distribution, and medical record documentation.
Main Results:
- High completion rates for the PAT (88% within 48 hours) and rapid result communication (98% within 48 hours).
- Risk stratification revealed 72% Universal, 24% Targeted, and 4% Clinical risk.
- Significantly more psychosocial risks were documented in the medical record with PAT compared to PAU.
Conclusions:
- The PAT is a feasible and effective tool for psychosocial risk screening in pediatric oncology.
- Implementation of the PAT enhances the documentation of psychosocial risks.
- While most families experience low psychosocial risk, a notable proportion require targeted or clinical support.
Background:
To investigate the feasibility of integrating an evidence-based screening tool of psychosocial risk in pediatric cancer care at diagnosis.
Methods:
Parents of children newly diagnosed with cancer received either the Psychosocial Assessment Tool (PAT; n=52) or psychosocial care as usual (n=47; PAU), based on their date of diagnosis and an alternating monthly schedule. Time to completion of the PAT, time to communication of PAT results to clinical care teams, distribution of PAT risk scores, and identification of psychosocial risks in the medical record were examined.
Results:
Of families receiving the PAT, 88% completed it within 48 hours. PAT was scored and results communicated within 48 hours in 98% of cases. Most families (72%) were classified as Universal risk based on the underlying Pediatric Psychosocial Preventative Health Model, 24% were classified as Targeted risk, and 4% scored in the Clinical range. Significantly more psychosocial risks were recorded in the medical record during PAT intervals than during PAU.
Conclusions:
An evidence-based psychosocial screener is feasible in pediatric oncology care and is associated with documentation of psychosocial risks in the medical record. Although the majority of families report low levels of psychosocial risk, about one-quarter report problems.
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