Purpose: Although families of pediatric liver transplant recipients have documented psychosocial needs, the systematic identification of needs and delivery of evidence-based care remain challenging. This project aimed to evaluate the Psychosocial Assessment Tool (PAT) as a feasible clinic-based screening measure of familial risk among pediatric liver transplant recipients.

Methods: Parent/guardians of patients within the Pediatric Liver Transplant Clinic completed the paper-based version of the PAT during their child's regularly scheduled clinic visit. The PAT is a validated screening measure comprised of 7 subscales: Family Structure and Resources, Social Support, Child Problems, Sibling Problems, Family Problems, Parent Stress Reactions, and Family Beliefs. Additional demographic information is also collected. The PAT takes approximately 5-10 minutes to complete. Items are scored dichotomously with 0=no risk and 1=risk. Risk subscale scores range from 0 to 1.00. A PAT Total score is calculated by summing subscale scores and ranges from 0 to 7. The PAT total score is mapped on to the Pediatric Psychosocial Preventative Health Model; PPPHM) using the following categories of risk: Universal (low), Targeted (medium), and Clinical (high). Data was analyzed using descriptive statistics, and the distribution of risk levels was compared to published risk levels across pediatric populations using Chi-Square analyses (Kazak, 2015).

Results: 101 parents/guardians of pediatric liver transplant recipients completed the PAT. Ninety percent of respondents were mothers. Mean age of recipients was 11 years (range:7 months-21 years), and mean time since transplant was 6.7 years (range 3 weeks – 19 years). Fifty-seven percent of families scored in the “Universal Risk” category, 34% scored in the “Targeted Risk” category, and 9% scored in the “Clinical Risk” category. This distribution across risk levels is comparable to risk observed in different pediatric settings and populations (p=0.77).

Conclusions: The PAT shows promise as a psychosocial screening measure to identify the risks and resiliencies in families of pediatric liver transplant recipients. Our program has incorporated the use of the PAT to inform clinical decision making and facilitate the provision of psychosocial care to address specific risk factors. Future analyses will examine the impact of screening on access to care and patient outcomes.

CITATION INFORMATION: Fredericks E, Smith T, Sevecke J, Eder S, Limke C, Shneider C, Lopez M. Use of the Psychosocial Assessment Tool to Identify Risk in Families of Pediatric Liver Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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