title: Validating a quality of life rating scale for idiopathic parkinsonism: Parkinson's Impact Scale (PIMS).
abstract: The signs and symptoms of idiopathic parkinsonism (IP, Parkinson's disease) are most commonly documented using one or more rating scales that assess physical limitations due to illness and drug side-effects with some attention being paid to depression. Scant attention has been paid to the impact of these limitations on a patient's life. Nurses in the Parkinson Foundation of Canada Clinical Assistance/ Outreach Programmes have designed a Quality of Life Rating Scale (Parkinson's Impact Scale, PIMS) to measure the impact of IP on 10 aspects of a patient's emotional, social and economic life. The scale had to fit onto one side of an 8 x 11 in. piece of paper, take a patient less than 10 min to complete, take fluctuations in symptoms ('on/off' attacks) into account, have unambiguous guidelines for the definition of each item, and a simple scoring system. A study was carried out to assess the reliability and validity of the scale. Nurses in nine Movement Disorder Clinics and one Outreach Programme participated. A total of 167 patients were asked to use the scale on three separate occasions, 1 month apart, without referring to the scores they had assigned to the scale in the previous month. Factor analysis identified four factors among the items in the scale: psychological, social, physical and financial. Internal consistency was 89.8% and the test-retest reliability was 72%. Construct validity was assessed by comparing factor scores and a global score between non-fluctuating patients and fluctuating patients in their 'off' state. The scores were significantly higher in the more severe 'off' state (p < 0.0001).
authors.affiliation: Neurodegenerative Disorders Centre, University of British Columbia, Vancouver, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Calne
authors.forename: M
authors.initials: M
authors.lastname: Schulzer
authors.forename: E
authors.initials: E
authors.lastname: Mak
authors.forename: C
authors.initials: C
authors.lastname: Guyette
authors.forename: G
authors.initials: G
authors.lastname: Rohs
authors.forename: S
authors.initials: S
authors.lastname: Hatchard
authors.forename: D
authors.initials: D
authors.lastname: Murphy
authors.forename: J
authors.initials: J
authors.lastname: Hodder
authors.forename: C
authors.initials: C
authors.lastname: Gagnon
authors.forename: S
authors.initials: S
authors.lastname: Weatherby
authors.forename: L
authors.initials: L
authors.lastname: Beaudet
authors.forename: J
authors.initials: J
authors.lastname: Duff
authors.forename: S
authors.initials: S
authors.lastname: Pegler