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Sharing psychosocial risk screening information with pediatric oncology healthcare providers: Service utilization and
Laurel Etkin-Spigelman1, Kelly Hancock1, Paul C Nathan1
1The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Providing psychosocial risk screening information to pediatric oncology care teams did not increase intervention rates. Treatment intensity, not screening, predicted psychosocial support for families facing childhood cancer.
Area of Science:
- Pediatric Oncology
- Psychosocial Care
- Healthcare Intervention Research
Background:
- Psychosocial morbidity is common in pediatric cancer patients and caregivers.
- Systematic psychosocial screening is recommended but not widely implemented.
- This study investigated the impact of providing screening information to treatment teams.
Purpose of the Study:
- To determine if informing healthcare providers of psychosocial risk increases documented psychosocial contacts.
- To examine the influence of demographic and clinical factors on intervention rates.
Main Methods:
- 93 families with newly diagnosed pediatric cancer patients participated.
- Randomized controlled trial: intervention group received psychosocial risk summaries (Psychosocial Assessment Tool - PAT).
- Control group received usual care; psychosocial intervention contacts were documented.
Main Results:
- No significant difference in psychosocial intervention rates between groups.
- Child's cancer treatment intensity was the sole significant predictor of intervention contacts (β = 0.396, P < 0.001).
Conclusions:
- Clinical factors, specifically treatment intensity, are stronger predictors of psychosocial intervention than providing screening information.
- Further research is needed to bridge the gap between screening, intervention, and family outcomes in pediatric oncology.
Background:
Psychosocial morbidity in pediatric oncology patients and their caregivers is widely recognized. Although routine systematic psychosocial screening has been proposed as a standard of care, screening is still limited. The present study assessed whether supplying the patient's treating team of healthcare providers with psychosocial risk screening information near diagnosis would increase the rate of documented psychosocial contacts, particularly for patients/families with elevated risk. The effect of demographic and clinical factors was also examined.
Procedures:
Ninety-three families with a child/youth newly diagnosed with cancer participated. Families were randomly assigned to a care as usual control group (n = 44) or an intervention group (n = 49) where the treating team was provided with a summary of family psychosocial risk, measured by the Psychosocial Assessment Tool (PAT). The PAT was completed by the primary caregiver, who also provided demographic information. The number of psychosocial intervention contacts documented in the medical charts was examined.
Results:
The rate of psychosocial intervention did not significantly differ between the groups (P > 0.05). The intensity of the child's cancer treatment was found to be the only significant predictor of the number of documented psychosocial intervention contacts (β = 0.396, P < 0.001).
Conclusions:
Clinical factors appear to be more predictive of the rate of psychosocial intervention provided to pediatric oncology patients and their families than informing the treating team of family psychosocial risk. Additional research is required to address the gap between psychosocial risk screening, psychosocial intervention, and family outcomes.
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