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The measurement of performance in childhood cancer patients
Insights
A new parent-rated Play-Performance Scale for children effectively measures performance status in pediatric cancer patients. This validated tool provides reliable data for monitoring and managing children with cancer.
Area of Science:
- Pediatric Oncology
- Child Health Outcomes
- Psychometrics
Background:
- Assessing child performance status is crucial in pediatric oncology.
- Existing measures for children's performance status are limited.
- A standardized, reliable tool is needed for pediatric cancer research and practice.
Purpose of the Study:
- To develop and standardize the Play-Performance Scale for children.
- To establish the scale's validity and reliability using parent raters.
- To provide a quantifiable measure for children's performance status in oncology.
Main Methods:
- Developed a parent-rated instrument, the Play-Performance Scale, focusing on usual play activity.
- Collected performance status ratings from pediatric cancer patients (n=98), siblings (n=29), and controls (n=40).
- Analyzed data using correlational statistics, percentage agreement, and analysis of variance (ANOVA) to assess reliability, validity, and sensitivity to change.
Main Results:
- Parents were confirmed as competent and reliable raters with good interrater agreement.
- The scale demonstrated validity, significantly discriminating between patient and sibling functioning levels (75.4 vs. 97.4).
- The scale correlated with clinician measures and was sensitive to changes in patient status (inpatients 42.3, outpatients 90.7, normals 98.2).
Conclusions:
- The Play-Performance Scale is a feasible, effective, and concise tool for assessing pediatric cancer patients' performance status.
- The scale provides quantifiable, reproducible data using parents as reporters, aiding in monitoring and management.
- This parent-rated instrument addresses the need for a standardized performance status measure in pediatric oncology.
Abstract:
The performance status of the child with cancer is an important outcome consideration in pediatric oncology research and practice. However, no single measure for children has been available. This is a report of the development and standardization of such a scale. The play-performance scale for children is a parent-rated instrument which records usual play activity as the index of performance. Performance status ratings were obtained on three groups of children: patients (n = 98), patients' siblings (n = 29), and an independent sample of hospital employees' children (n = 40). Children with all types and stages of childhood malignant neoplasms were represented. Test results established the parent as a competent, reliable rater and demonstrated the validity of the scale. Interrater reliability was examined using correlational statistics and percentage agreement. Agreement between parents was good, and there were no systematic rater biases. In addition, parents' ratings significantly discriminated differences in levels of functioning (mean score, patients 75.4 versus siblings 97.4). Correlational and analysis of variance (ANOVA) procedures demonstrated that the play-performance scale was significantly related to the global performance measures of experienced clinicians and was sensitive to change. Inpatients received a mean score of 42.3, outpatients 90.7, and normals 98.2. These findings indicate that the scale is both feasible and effective. It is concise, can be administered repeatedly even to extremely ill patients, and uses parents as observer reporters. The play-performance scale for children provides quantifiable, reproducible, and meaningful data, which is necessary for effective monitoring and management of the child with cancer.