ABSTRACT
BACKGROUND: Childhood cancer is associated with child adjustment difficulties including, eating and sleep disturbance, and emotional and other behavioral difficulties. However, there is a lack of validated instruments to measure the specific child adjustment issues associated with pediatric cancer treatments. The aim of this study was to develop and evaluate the reliability and validity of a parent-reported, child adjustment scale. PROCEDURE: One hundred thirty-two parents from two pediatric oncology centers who had children (aged 2-10 years) diagnosed with cancer completed the newly developed measure and additional measures of child behavior, sleep, diet, and quality of life. Children were more than 4 weeks postdiagnosis and less than 12 months postactive treatment. Factor structure, internal consistency, and construct (convergent) validity analyses were conducted. RESULTS: Principal component analysis revealed five distinct and theoretically coherent factors: Sleep Difficulties, Impact of Child's Illness, Eating Difficulties, Hospital-Related Behavior Difficulties, and General Behavior Difficulties. The final 25-item measure, the Children's Oncology Child Adjustment Scale (ChOCs), demonstrated good internal consistency (α = 0.79-0.91). Validity of the ChOCs was demonstrated by significant correlations between the subscales and measures of corresponding constructs. CONCLUSION: The ChOCs provides a new measure of child adjustment difficulties designed specifically for pediatric oncology. Preliminary analyses indicate strong theoretical and psychometric properties. Future studies are required to further examine reliability and validity of the scale, including test-retest reliability, discriminant validity, as well as change sensitivity and generalizability across different oncology samples and ages of children. The ChOCs shows promise as a measure of child adjustment relevant for oncology clinical settings and research purposes.
Subject(s)
Adaptation, Psychological , Child Behavior , Neoplasms/psychology , Quality of Life , Stress, Psychological/diagnosis , Child , Child, Preschool , Emotions , Female , Follow-Up Studies , Humans , Male , Medical Oncology , Neoplasms/diagnosis , Prognosis , Psychometrics , Stress, Psychological/etiology , Surveys and QuestionnairesABSTRACT
This study examined the feasibility of implementing the Psychosocial Assessment Tool (PAT2.0) from the perspectives of families and health-care providers (HCPs). PAT2.0 data were collected from 104 families. Individual and focus group interviews were conducted with HCPs. Parents reported that the PAT2.0 was brief and easy to complete. HCPs' perspectives on the utility of the PAT2.0 were mixed and varied according to clinical roles. A major perceived benefit was the PAT2.0 as a communication tool. Barriers included timing and an increased workload for social workers. Psychosocial screening represents a significant practice change for oncology HCPs and is an important area of ongoing research.