title: Systematic psychosocial screening in a paediatric cardiology clinic: clinical utility of the Pediatric Symptom Checklist 17.
abstract: OBJECTIVE
  To examine the clinical utility of the Pediatric Symptom Checklist 17 for identifying psychosocial concerns and improving access to psychology services within a paediatric cardiology clinic.
  
  
  METHODS
  Parents of 561 children (aged 4-17 years) presenting for follow-up of CHD, acquired heart disease, or arrhythmia completed the Pediatric Symptom Checklist 17 as part of routine care; three items assessing parental (1) concern for learning/development, (2) questions about adjustment to cardiac diagnosis, and (3) interest in discussing concerns with a behavioural healthcare specialist were added to the questionnaire. A psychologist contacted the parents by phone if they indicated interest in speaking with a behavioural healthcare specialist.
  
  
  RESULTS
  Percentages of children scoring above clinical cut-offs for externalising (10.5%), attention (8.7%), and total (9.3%) problems were similar to a "normative" primary-care sample, whereas fewer children in this study scored above the cut-off for internalising problems (7.8%; p<0.01). Sociodemographic, but not clinical, characteristics were associated with Pediatric Symptom Checklist 17 scores. 17% of the parents endorsed concerns about learning/development, and 20% endorsed questions about adjustment to diagnosis. History of cardiac surgery was associated with increased concern about learning/development (p<0.01). Only 37% of the parents expressing psychosocial concerns reported interest in speaking with a psychologist.
  
  
  CONCLUSIONS
  The Pediatric Symptom Checklist 17 may not be sensitive to specific difficulties experienced by this patient population. A questionnaire with greater focus on learning/development and adjustment to diagnosis may yield improved utility. Psychology integration in clinics serving high-risk cardiac patients may decrease barriers to behavioural healthcare services.
authors.affiliation: 1Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Kari L
authors.initials: KL
authors.lastname: Struemph
authors.affiliation: 1Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Lydia R
authors.initials: LR
authors.lastname: Barhight
authors.affiliation: 2Nemours Cardiac Center,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Deepika
authors.initials: D
authors.lastname: Thacker
authors.affiliation: 1Division of Behavioral Health,Nemours/Alfred I. duPont Hospital for Children,Wilmington,Delaware,United States of America.
authors.forename: Erica
authors.initials: E
authors.lastname: Sood
mesh_terms: D000293:Adolescent; D057189:Checklist / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D008297:Male; D010290:Parents; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests / Q000592:standards*; D066233:Psychology, Developmental; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: CHD; neurodevelopment; psychology; psychosocial screening