Reliability, validity and applicability of the Flemish adaption of the pat:A multicenter study

Abstract

Background and Aims: The Psychosocial Assessment Tool (PAT) is a tool to screen for psychosocial risk factors in families confronted with a child with cancer. We translated the PAT for the Flemish speaking part of Belgium using the forward-backward procedure. The aim of the present study was to investigate the reliability, validity, usability, and clinical added value of the PAT. Methods: In two pediatric oncological centers in Belgium (UZGent/UZLeuven) families confronted with a new diagnosis of childhood cancer were asked to complete the PAT and additional questionnaires (e.g., usability of PAT). The multidisciplinary team rated these families in one of the three risk categories (universal, targeted and clinical). A Spearman rank correlation was used to investigate agreement between PAT and team scores. Results: A total of 106 families participated in the study. The completion of the PAT was on average 37 days after diagnosis. The reliability of the total PAT score (α=.86) and most of the subscales was adequate to good (α=.64-.88). One subscale was inadequate (Family Beliefs, (α=.45)). Content validity was adequate (r=.30-.62), except for the 'social support' subscale. The usability of the PAT, as rated by the parents was adequate to good. Based on the total PAT score 68%, 26% and 6% of the families were classified in the universal, targeted and clinical group, respectively. A modest correlation between the PAT and the team's assessment was found (r= .38, p<.001). According to the assessment of the team, 36%, 48% and 17% were classified in the universal, targeted and clinical group, respectively. Conclusions: Our study demonstrates the reliability, validity, and applicability of the Flemish adaptation of the PAT. More research is required to evaluate the added clinical value of combining different assessments (i.c. PAT and multidisciplinary evaluation) of psychosocial risk factors in order to optimize psychosocial support of families confronted with a child with cancer