A new screening tool for determining occupational therapy needs in hospitalized children with cancer: a validity and reliability study.
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UNLABELLED: Determining the occupational therapy needs of hospitalized children with cancer is important. The present study was conducted to evaluate the validity, reliability, and clinical utility of a 25-item checklist developed to quickly and accurately identify occupational therapy needs in pediatric cancer. This cross-sectional methodological study included 402 children with cancer (aged 6-17 years). Construct validity was evaluated using exploratory factor analysis with the unweighted least squares method based on a tetrachoric correlation matrix. Internal consistency reliability was assessed using Kuder-Richardson 20 (KR-20) and McDonald's Omega (ω) coefficients. Clinical utility and known-groups validity were examined via quartile analysis and the Kruskal-Wallis H test. Regarding construct validity, parallel analysis and Scree Plot evaluation confirmed a strong unidimensional structure measuring the general occupational therapy needs construct, replacing the initial multidimensional assumptions. The checklist demonstrated excellent internal consistency (KR-20 = 0.881, ω = 0.888). Known-groups validity analysis revealed significant differences among diagnostic groups (p = 0.005). Post hoc tests indicated that the central nervous system and solid organ tumors group had significantly higher occupational therapy needs compared to the bone and soft tissue tumors group (p = 0.004). Regarding clinical utility, quartile analysis effectively classified patients into low, moderate, and high-priority triage groups. CONCLUSION: The 25-item checklist is a highly valid and reliable screening tool for determining the occupational therapy needs of children with cancer. Its clinical utility, reflected in its ability to rapidly classify patients into priority groups, supports its integration into busy clinical workflows. We recommend its use for rapid triaging and routine assessment in busy clinical settings. WHAT IS KNOWN: • Children with cancer experience functional limitations, but current assessment methods are time-consuming. • There is a lack of rapidly applicable screening tools for occupational therapy needs in intensive clinical workflows. WHAT IS NEW: • A 25-item checklist demonstrated evidence of validity, reliability, and a unidimensional structure as a clinical screening tool. • The tool categorizes patients into triage priority groups, which may support clinical decision making.