title: Identifying psychosocial risk indicative of subsequent resource use in families of newly diagnosed pediatric oncology patients.
abstract: OBJECTIVE
  The primary purpose of this prospective study was to identify the level of risk for psychosocial distress in families of children newly diagnosed with cancer. Additional study aims were to examine concordance among family and staff reports of psychosocial risk, changes in risk status over time, and to predict the use of psychosocial resources during the first months of treatment.
  
  
  METHODS
  Caregivers of 125 children newly diagnosed with cancer completed the Psychosocial Assessment Tool (PAT) at diagnosis (t1) and 3 to 6 months later (t2). Primary oncologists and nurses completed an analogous measure of perceived family psychosocial risk at t1 and t2. At t2, oncology social workers reported types and intensity of psychosocial interventions provided.
  
  
  RESULTS
  The PAT identified three subsets of families who presented with increasing levels of psychosocial risk at diagnosis. In general, there was moderate concordance among family, oncologist, and nurse reports of psychosocial risk. PAT scores at t1 predicted t2 PAT scores and psychosocial resource use at t2 beyond demographic or disease factors.
  
  
  CONCLUSIONS
  A brief screening tool (PAT) is valuable in identifying psychosocial risk factors at diagnosis and is predictive of later use of psychosocial resources. As a next step in this research, the development of psychosocial interventions to match family risk level may be an effective and cost-efficient approach to working with families to address their concerns and promote short- and long-term adjustment.
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Room 1486 CHOP North, 34th St and Civic Center Blvd, Philadelphia, PA 19104, USA. kazak@e-mail.chop.edu.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Kazak
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Cant
authors.forename: Merritt M
authors.initials: MM
authors.lastname: Jensen
authors.forename: Mary
authors.initials: M
authors.lastname: McSherry
authors.forename: Mary T
authors.initials: MT
authors.lastname: Rourke
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hwang
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Alderfer
authors.forename: David
authors.initials: D
authors.lastname: Beele
authors.forename: Steven
authors.initials: S
authors.lastname: Simms
authors.forename: Beverly J
authors.initials: BJ
authors.lastname: Lange
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors