Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T06:36:07.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Systematic psychosocial screening in a paediatric cardiology clinic: clinical utility of the Pediatric Symptom Checklist 17

Published online by Cambridge University Press:  01 October 2015

Kari L. Struemph ,
Lydia R. Barhight ,
Deepika Thacker  and
Erica Sood
Kari L. Struemph
Affiliation:
Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Lydia R. Barhight
Affiliation:
Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Deepika Thacker
Affiliation:
Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
Erica Sood*
Affiliation:
Division of Behavioral Health, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: E. Sood, PhD, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, United States of America. Tel: 302 651 6304; Fax: 302 651 5345; E-mail: erica.sood@nemours.org
Get access Rights & Permissions [Opens in a new window]

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.

Method

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.

Keywords

CHDpsychosocial screeningneurodevelopmentpsychology
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1130 - 1136
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Khairy, P, Ionescu-Ittu, R, Mackie, AS, Abrahamowicz, M, Pilote, L, Marelli, AJ. Changing mortality in congenital heart disease. J Am Coll Cardiol 2010; 56: 1149–1157.Google Scholar
2. Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 2012; 126: 1143–1172.Google Scholar
3. Czosek, RJ, Bonney, WJ, Cassedy, A, et al. Impact of cardiac devices on the quality of life in pediatric patients. Circ Arrhythm Electrophysiol 2012; 5: 1064–1072.Google Scholar
4. Sears, SF St, Amant, JB, Zeigler, V. Psychosocial considerations for children and young adolescents with implantable cardioverter defibrillators: an update. Pacing Clin Electrophysiol 2009; 32 (Suppl 2): S80–S82.Google Scholar
5. Brosig, C, Butcher, J, Butler, S, et al. Monitoring developmental risk and promoting success for children with congenital heart disease: recommendations for cardiac neurodevelopmental follow-up programs. Clin Pract Pediatr Psychol 2014; 2: 153–165.Google Scholar
6. Brosig, C, Yang, K, Hoffmann, RG, Dasgupta, M, Mussatto, K. The role of psychology in a pediatric outpatient cardiology setting: preliminary results from a new clinical program. J Clin Psychol Med Settings 2014; 21: 337–346.Google Scholar
7. Borowsky, IW, Mozayeny, S, Ireland, M. Brief psychosocial screening at health supervision and acute care visits. Pediatrics 2003; 112: 129–133.Google Scholar
8. Gardner, W, Lucas, A, Kolko, DJ, Campo, JV. Comparison of the PSC-17 and alternative mental health screens in an at-risk primary care sample. J Am Acad Child Adolesc Psychiatry 2007; 46: 611–618.Google Scholar
9. Guilfoyle, SM, Wagner, JL, Smith, G, Modi, AC. Early screening and identification of psychological comorbidities in pediatric epilepsy is necessary. Epilepsy Behav 2012; 25: 495–500.Google Scholar
10. Maddux, MH, Bass, JA, Geraghty-Sirridge, C, Carpenter, E, Christenson, K. Assessing psychosocial functioning among youth with newly diagnosed inflammatory bowel disease (IBD): an interdisciplinary clinic approach. Clin Pract Pediatr Psychol 2013; 1: 333–343.Google Scholar
11. Jellinek, MS, Murphy, JM, Robinson, J, Feins, A, Lamb, S, Fenton, T. Pediatric Symptom Checklist: screening school-age children for psychosocial dysfunction. J Pediatr 1988; 112: 201–209.Google Scholar
12. Gardner, W, Murphy, M, Childs, G, et al. The PSC-17: a brief pediatric symptom checklist with psychosocial problem subscales. A report from PROS and ASPN. Ambul Child Health 1999; 5: 225–236.Google Scholar
13. Hearps, SJ, McCarthy, MC, Muscara, F, et al. Psychosocial risk in families of infants undergoing surgery for a serious congenital heart disease. Cardiol Young 2014; 24: 632–639.Google Scholar
14. Pulgaron, ER, Wile, D, Schneider, K, Young, ML, Delamater, AM. Quality of life and psychosocial functioning of children with cardiac arrhythmias. Cardiol Young 2013; 23: 82–88.Google Scholar
15. Wernovsky, G. Current insights regarding neurological and developmental abnormalities in children and young adults with complex congenital cardiac disease. Cardiol Young 2006; 16 (Suppl 1): 92–104.Google Scholar
16. Cassedy, A, Drotar, D, Ittenbach, R, et al. The impact of socio-economic status on health related quality of life for children and adolescents with heart disease. Health Qual Life Outcomes 2013; 11: 99.Google Scholar
17. Lawoko, S, Soares, JJ. Distress and hopelessness among parents of children with congenital heart disease, parents of children with other diseases, and parents of healthy children. J Psychosom Res 2002; 52: 193–208.Google Scholar
18. Logan, B, Woodford, E, Struemph, K, Chopko, S, Sood, E. Posttraumatic stress symptoms in parents of children with complex congenital heart disease. Poster presented at the Society of Pedatric Psychology Annual Conference; 2014; Philadelphia, PA.Google Scholar
19. Owens, PL, Hoagwood, K, Horwitz, SM, et al. Barriers to children's mental health services. J Am Acad Child Adolesc Psychiatry 2002; 41: 731–738.Google Scholar
20. Anderson, B, Loughlin, C, Goldberg, E, Laffel, L. Comprehensive, family-focused outpatient care for very young children living with chronic disease: lessons from a program in pediatric diabetes. Child Serv Soc Pol Res Pract 2001; 4: 235–250.Google Scholar
21. Guilfoyle, SM, Follansbee-Junger, K, Modi, AC. Development and preliminary implementation of a psychosocial service into standard medical care for pediatric epilepsy. Clin Pract Pediatr Psychol 2013; 1: 276–288.Google Scholar