Pediatric Psychosocial Oncology: Textbook for Multidisciplinary Care

Cushing/Whitney Medical Library

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There was only moderate, inter-rater reliability between patient, caregiver and medical provider ratings, and the strength of this association increased with patient age. Weiner et al. Additionally, the CDI-S and the BSI, the validating measures for depression, identified several patients who were having thoughts of suicide. These findings suggest future screening measures include a direct question about suicidal thoughts and intent. One of the primary strengths of this study includes the large sample of children and adolescents with a diverse set of medical conditions in two sites, which helps to demonstrate the overall flexibility and utility of the DT.

ISBN 10: 3319213733

This sample included children with different sets of symptoms, treatment related adverse effects and therefore, different psychosocial implications. The sample also included a wide pediatric age range, from 7 to 21, which encompasses a diverse set of developmental stages and potential psychosocial stressors. The study is limited by the cross-sectional nature of the data and the fact that caregivers are largely represented by mothers. Fathers and other types of caregivers were not highly prevalent in this sample; however, the proportion of mothers in the sample resembles that in studies of parent gender and caregiving for an ill child Given the ease of administration and valid identification of psychosocial distress, even on repeated intervals 19 , this tool may well be useful to monitor psychosocial distress across the trajectory of a variety of illnesses.

Some research suggests that an electronic format compared to a paper version demonstrates greater compliance and accuracy; future distress screening in pediatrics should include electronic versions To increase clinical utility, a summary report should be developed for the pediatric medical provider to provide real time feedback. This clinical summary can, in turn, improve communication with medical providers about psychosocial needs and, hopefully, prevent chronic distress or more serious problems.

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Europe PMC requires Javascript to function effectively. Recent Activity. Psychosocial distress is under-recognized in children with cancer and other serious medical illnesses because of a focus on pressing medical concerns. Two hundred eighty-one patient-caregiver-provider triads were enrolled from two hospital outpatient clinics.

Patients diagnosed with cancer and other life-threatening diseases, caregivers, and providers completed the DT and a DT acceptability rating. Patients and caregivers completed standardized measures of anxiety, depression, pain, and fatigue. Providers completed a measure of disease severity. Data collectors completed a feasibility rating.

The DT was significantly correlated with both caregiver and patient reports of depression, anxiety, pain, and fatigue, exhibiting concurrent validity. Parent, child, and caregiver report demonstrated significant, moderate inter-rater reliability, with lower concordance between raters in the youngest age group.

The DT is a sensitive instrument for screening of psychosocial distress when compared with the selected gold standard Brief Symptom Inventory 18 depression subscale and the Children's Depression Inventory. The DT is not highly specific but quickly identifies those in need of further psychosocial assessment.

History of the Fellows of the American Psychosocial Oncology Society

Screening, using an adapted pediatric DT, is valid, feasible, and acceptable to patients, caregivers, and medical providers across chronic medical illnesses. As patient and caregiver reports are not always concordant, both patient and caregiver report of distress are important for the provider to obtain clinically meaningful information to guide interventions.

Published This article is a U.

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This may be because the snippet appears in a figure legend, contains special characters or spans different sections of the article. Author manuscript; available in PMC Apr 1. PMID: Widemann , 1 and Maryland Pao 2. Brigitte C. Copyright notice. See other articles in PMC that cite the published article.

Introduction New medical therapies and early detection have greatly increased survival rates of children with serious medical illnesses. Open in a separate window.

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Measures Distress Thermometer The NCCN DT is a self-report tool that asks patients to rate their emotional distress and caregivers and medical providers, about the patients on a visual analog scale designed to appear as a thermometer. The Brief Symptom Inventory 18 BSI The BSI 25 is an item self-report measure to screen for psychological distress and psychiatric disorders in medically ill patients in the community or hospital settings.

Lansky and Karnofsky Scores Medical providers completed a Lansky score for patients 17 years and younger and a Karnofsky score for patients 18 years and older. Procedure Patients were recruited by a study investigator at either hospital and all data collection was completed in a single clinic visit. Inter-rater reliability DT ratings between patient, caregiver and medical provider exhibited modest inter-rater reliability, with the overall intra-class correlation coefficient at.

Table 3 Inter-rater reliability, overall and by age. Intra-class correlation All raters — All ages. Feasibility Data collectors reported that administering the DT in an outpatient setting is highly feasible for Acceptability Patients, caregivers and medical providers all indicated high acceptability of the DT as a tool to be completed in the clinic visit.

Discussion Medical teams often first become aware of significant emotional distress once it becomes acute, such as when a child is not adherent to medications, severely depressed or even suicidal Strengths and Limitations One of the primary strengths of this study includes the large sample of children and adolescents with a diverse set of medical conditions in two sites, which helps to demonstrate the overall flexibility and utility of the DT. Future directions Given the ease of administration and valid identification of psychosocial distress, even on repeated intervals 19 , this tool may well be useful to monitor psychosocial distress across the trajectory of a variety of illnesses.

References 1.

Growing up in the hospital. Journal of the American Medical Association. Turkel S, Pao M. Late consequences of chronic pediatric illness.

Psychiatric Clinics of North America. Consultation-liaison in child psychiatry: A review of the past 10 years. Part I: Clinical findings. Journal of the National Comprehensive Cancer Network. A prospective study of anxiety, depression, and behavioral changes in the first year after a diagnosis of childhood acute lymphoblastic leukemia. Psychological distress as a barrier to preventive care in community-dwelling elderly in the United States. Medical Care. Nonadherence in adolescent oncology patients: Preliminary data on psychological risk factors and relationships to outcome.

Journal of Clinical Psychology in Medical Settings. Institute of Medicine. Cancer Care for the Whole Patient. Oncology Nursing Forum. Professional societies endorse standard for cancer center accreditation by commission on cancer. Pediatric psychosocial oncology: A textbook of multidisciplinary care. Springer International Publishing Switzerland; Assessing family psychosocial risks in pediatric cancer. Psychosocial assessment as a standard of care in pediatric oncology.

Pediatr Blood Cancer. Distress screening, rater agreement, and services in pediatric oncology. Changes in self-reported distress in end-of-life pediatric cancer patients and their parents using the pediatric distress thermometer. Date de publication.

Code Interne. Adobe DRM. Stock en magasins. Notre conseil. Magasins proches. Tous les magasins. In some cases the evidences available are not as hard as those supporting drug treatments: many outcomes such as the effectiveness of educational interventions, the patients' wellbeing, thrust, perception of support, for their nature and complexity require both quantitative and qualitative measurements.

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