Parent Caring Response Scoring System: development and psychometric evaluation in the context of childhood cancer-related port starts.
Jinbing Bai, Kristen Swanson, Felicity W K Harper and 2 others
PMID 28869662WHAT IT FOUND
A new parent-behavior coding system for children's cancer port starts showed acceptable coder agreement and preliminary links to parent distress, child distress and cooperation.
It was tested only in port starts, mainly with mothers, so do not assume it measures other procedures or fathers.
Key findings
01The P-CaReSS is an 18-item coding system for parent verbal, nonverbal and emotional behaviors during port starts, grouped into five caring domains and one non-caring domain.
02Inter-rater agreement was acceptable overall, with average agreement 0.82 and kappa 0.81 for emotional behavior.
03Several P-CaReSS codes were significantly correlated with child distress and child cooperation ratings by at least one rater.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The coding system was developed and tested only during cancer treatment port starts, so it is not established for lumbar punctures, bone marrow aspirations or other painful procedures. The psychometric sample was small: 11 dyads were used for inter-rater reliability and 43 dyads for construct validity. Most parents were female, so the results may not apply to fathers. Coding was based on 5-minute thin slices of the port start, so behaviors outside the slice may have been missed. Several codes did not occur during reliability testing, including apologizing, so their measurement is unproven in this sample. The study reports correlations, not effects, so it cannot show that parent behaviors caused child distress or that changing them helps. The tool was not compared with existing observational measures such as the CAMPIS-R.
Declared interests
The supplied text does not include a conflicts-of-interest or funding declaration for this study. It notes that some video data came from a parent study funded by grant R01CA138981.
The easy way to misread this
Do not read this as evidence that teaching parents to behave differently will reduce a child's distress during port starts. The study only coded observed parent behaviors and correlated them with distress and cooperation ratings. It did not test an intervention, and some expected caring behaviors did not correlate with child distress.