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Screening for Psychosocial Risk at Pediatric Cancer Diagnosis: The Psychosocial Assessment Tool

Kazak, Anne E. PhD, ABPP*,†; Barakat, Lamia P. PhD*,†; Ditaranto, Susan RN, MHA*; Biros, Daniel BA*; Hwang, Wei-Ting PhD; Beele, David MSW, LSW*; Kersun, Leslie MD*,†; Alderfer, Melissa A. PhD*,†; Mougianis, Ifigenia AB*; Hocking, Matthew C. PhD*; Reilly, Anne MD*,†

Journal of Pediatric Hematology/Oncology: May 2011 - Volume 33 - Issue 4 - p 289–294
doi: 10.1097/MPH.0b013e31820c3b52
Original Articles

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.

*Division of Oncology, The Children's Hospital of Philadelphia

Department of Pediatrics

Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania School of Medicine, Philadelphia, PA

This research was supported by St Baldrick's Foundation.

Reprints: Anne E. Kazak, PhD, ABPP, Division of Oncology, The Children's Hospital of Philadelphia, Room 1486 CHOP North, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (e-mail:

Received September 17, 2010

Accepted December 13, 2010

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.