Objective
There are many studies of the Pediatric Symptom Checklist (PSC), but none has followed
a naturalistic sample longitudinally. We aimed to examine persistence and change in
PSC scores over time in children seen in an ambulatory pediatric setting.
Methods
The sample of 1033 patients was PSC screened at 2 consecutive preventive care visits
(10 to 18 months apart) in 2 pediatric clinics. Longitudinal analyses were conducted
to assess predictors of change in PSC category and score.
Results
Approximately 30% of the initially screened population did not return for preventive
pediatric care. Those who did not return were significantly more likely to have positive
PSC scores than those who returned (8% compared with 4.3%, P < .01). PSC scores were highly stable at visit 2 for those who initially scored negative,
but they fluctuated more for those who initially scored positive. After controlling
for sociodemographic variables and counseling at either visit, referral at visit 1
(P < .0001) predicted changes in mean PSC scores at visit 2. On average, PSC score decreased
3.2 points among those referred at visit 1 but increased 1.6 points in nonreferred
children.
Conclusions
This is the first study to document the stability and change in PSC scores in a sample
of ambulatory pediatric patients. The statistically significant association between
pediatrician referral and improved PSC scores provides evidence for the value of referral
in primary care, although the study did not examine the relationship between PSC screening
and referral. The high rate of positive scores in children who did not return for
follow-up suggests the need for alternative strategies for this population.
Key Words
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Article Info
Publication History
Published online: June 01, 2009
Accepted:
March 17,
2009
Received:
June 3,
2008
Identification
Copyright
© 2009 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
