Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool

Abstract Objective Family psychosocial risk screening is an important initial step in delivering evidence-based care in hematopoietic stem cell transplantation (HCT). Establishing an evidence-based screening approach that is acceptable, reliable and valid is an essential step in psychosocial care delivery. Methods This is a three-institution multi-method study. In Part 1 caregivers of children about to undergo HCT (n = 140) completed the Psychosocial Assessment Tool (PAT), a brief parent report screener adapted for HCT, and validating questionnaires. Families received feedback on their risks identified on the PAT. In Part 2, 12 caregivers completed a semi-structured interview about their perceptions of the PAT and the feedback process. The reliability and validity of the PAT-HCT total and subscales scores were tested using Kuder-Richardson-20 (KR-20) and Pearson correlations. Thematic content analysis was used to analyze the qualitative interview data. Results Internal consistency for the total score (KR-20 = 0.88) and the Child Problems, Sibling Problems, Family Problems and Stress Reactions subscales were strong (KR-20 > 0.70). Family Structure, Social Support and Family Beliefs subscales were adequate (KR-20 = 0.55 – 0.63). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Feedback was provided to 97.14% of the families who completed the PAT-HCT and mean ratings of acceptability were above 4.00 (5-point scale). The qualitative data indicate that families appreciate the efforts to provide screening and feedback. Conclusions The PAT-HCT is a psychometrically sound screener for use in HCT. Feedback can be given to families. Both the screener and the feedback process are acceptable to caregivers.