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Feasibility of single question mental health surveillance in chronic disease
  1. Mary White1,2,
  2. Rachel Pelly1,
  3. Jane Le3,
  4. Lucy Dove4,
  5. Sarah Connolly5,
  6. Alice Morgan6,
  7. Dave Reid6,
  8. Ric Haslam7,
  9. Harriet Hiscock8,9
  1. 1 Health Services Research Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  2. 2 Endocrinology and Diabetes, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  3. 3 Murdoch Children's Research Institute Health Services Group, Parkville, Victoria, Australia
  4. 4 Day Medical Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  5. 5 Social Work and Pastoral Care Services, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  6. 6 Clinical Psychology Services, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  7. 7 Mental Health Service, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  8. 8 Health Services Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  9. 9 Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Mary White, Health Services Research Unit, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; mary.white{at}rch.org.au

Abstract

Objective To determine the (1) feasibility and acceptability of administering single question mental health surveillance to carers of children with chronic disease in the inpatient setting and (2) sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this question to detect ‘at risk’ children compared with the Strengths and Difficulties Questionnaire (SDQ).

Design Cross-sectional pilot

Setting Day Medical Unit of a tertiary paediatric hospital, 1 April 2021–31 July 2021.

Patients Carers of children aged 2–17 years with chronic medical conditions.

Interventions Caregivers were asked to respond to ‘Thinking about your child’s mental health over the past 4 weeks, are they thriving/coping/struggling/always overwhelmed?’ during the admission process. All carers and children 11–17 years were invited to complete the SDQ.

Main outcome measures Feasibility and acceptability were determined by nursing feedback. Sensitivity, specificity, PPV and NPV were determined by comparing question responses with clinical cut-points on the SDQ.

Results 213 carers responded to the question. Nurses reported that the question was easy (12/14) or moderately easy (2/14) to use and was ‘easily understood’ (6/14) or ‘understood after some explanation’ (8/14) for most carers. The question demonstrated a high specificity (0.98)/PPV (0.87) but low sensitivity (0.2) when thriving/coping were considered together whereas when thriving was compared with all other responses the sensitivity increased to 0.7.

Conclusions Single question mental health surveillance appears acceptable to carers and nursing staff and has a high level of specificity for children who are ‘struggling’ or ‘always overwhelmed’ versus the SDQ screening measure.

  • Child Psychiatry
  • Health services research
  • Nursing Care
  • Paediatrics
  • Psychology

Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information.

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Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information.

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Footnotes

  • Contributors This project was devised by HH and was designed in collaboration with all contributing authors. MW was the primary project officer and oversaw all aspects of recruitment, data collection, data analyses and drafted the manuscript. All authors reviewed and contributed to the final submitted article. MW is the guarantor of this work and accepts respnsibility for the final manuscript.

  • Funding No member of the investigating team has any financial disclosures or conflict of interest relevant to this study which was funded by a RCH Foundation grant (#987). HH is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (1136222).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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