Preliminary validation of PRISM (Pictorial Representation of Illness and Self Measure) - a brief method to assess suffering.
BACKGROUND
Alleviation of suffering is widely acknowledged as one of the main goals of medicine. However, no measure to assess this crucial aspect of illness has been developed to date.


OBJECTIVE
To validate PRISM (Pictorial Representation of Illness and Self-Measure) as a simple quantitative method of assessing the perceived burden of suffering due to illness.


METHODS
Validity and reliability studies to date have involved over 700 patients with a variety of chronic physical illnesses.


RESULTS
Reliability of PRISM is good (test-retest reliability r = 0.95; p < or = 0.001, interrater reliability r = 0.79; p < or = 0.001). Qualitative data indicate that the interpretation of the PRISM task is not only consistent among patients, but also consistent with that expected from existing literature on suffering. As expected, PRISM shows strong correlations with psychological variables (notably depression and coping resilience) and also correlates with SF-36 subscale scores. Prospective longitudinal data demonstrate that PRISM is sensitive to therapeutic change. It is very acceptable to patients and takes less than 5 min to administer.


CONCLUSIONS
In the absence of a 'gold standard' measure of suffering, our validation data must be interpreted with caution. However, the performance of PRISM is entirely consistent with what would be expected of a measure of suffering, based on current published work.
Büchi
Stefan
S
Psychiatric Department, University Hospital Zürich, Switzerland. sbuechi@psyp.unizh.ch
Buddeberg
Claus
C
Klaghofer
Richard
R
Russi
Erich W
EW
Brändli
Otto
O
Schlösser
Corinne
C
Stoll
Thomas
T
Villiger
Peter M
PM
Sensky
Tom
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014796:Visual Perception