Assessing pediatric patient's risk of distress during health-care encounters: The psychometric properties of the Psychosocial Risk Assessment in Pediatrics

J Child Health Care. 2014 Dec;18(4):378-87. doi: 10.1177/1367493513496671. Epub 2013 Aug 12.


The aim of this study was to examine the psychometric properties of the Psychosocial Risk Assessment in Pediatrics (PRAP). PRAP is a screening tool designed to assess pediatric patients who are at risk of experiencing elevated distress during health-care encounters. A cross-sectional observational study was conducted with 200 pediatric patients. Patient's distress levels were observed during their health-care encounter using the Children's Emotional Manifestation Scale (CEMS). Health-care staff and parents were asked to rate the patient's level of cooperation and stress. Exploratory factor analysis supported a single latent factor structure of the PRAP tool. Cronbach's α for internal reliability was .83. PRAP score was strongly correlated with CEMS score with r = .82 (p < .0001). The PRAP is a standardized, reliable, and valid method for health-care providers to assess a patient's risk of experiencing significant distress during treatment or testing.

Keywords: Assessment; PRAP; child life; coping; distress; psychosocial risk.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Delivery of Health Care*
  • Emotions
  • Female
  • Humans
  • Infant
  • Male
  • Psychology, Child
  • Psychometrics / methods*
  • Reproducibility of Results
  • Risk Assessment
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / etiology
  • Young Adult