title: PRISM (pictorial representation of illness and self measure): a novel visual instrument to assess pain and suffering in orofacial pain patients.
abstract: OBJECTIVE
  To use PRISM (Pictorial Representation of Illness and Self Measure), a visual instrument that has recently been developed and validated to assess suffering in patients with chronic physical illness, in orofacial pain patients and test for associations of PRISM with established assessment tools for pain, affective symptoms, and sleep. Of particular interest was the utility of PRISM as a screening tool for severely suffering patients.
  
  
  METHODS
  One hundred and two orofacial pain patients recruited from a specialized outpatient service completed a questionnaire-based survey, including established assessment tools: the Visual Analog Scale (VAS), Graded Chronic Pain Scale (GCPS), the Hospital Anxiety and Depression Scale (HADS), and the Insomnia Severity Index (ISI), as well as a paper and pencil version of PRISM.
  
  
  RESULTS
  Of the 102 patients who submitted the clinical questionnaire, 74 performed the PRISM-test (response rate: 72%). PRISM scores correlated strongly with all subscores of pain (measured by GCPS) and sleep (measured by ISI). Further, a trend was observed in the correlation with affective symptoms measured by the HADS. PRISM could readily detect patients with high, pain-related suffering.
  
  
  CONCLUSIONS
  These data add support to the hypothesis that the PRISM task in its paper and pencil version is measuring the burden of suffering. The clinical utility of this simple graphic tool therefore lies in its potential to alert clinicians to a high burden of suffering and thus it may help to identify orofacial pain patients who may benefit from more comprehensive assessment and treatment. Prospective studies are needed to clarify this claim.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Zurich, Switzerland.
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Streffer
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Mörgeli
authors.forename: Ursula
authors.initials: U
authors.lastname: Galli
authors.forename: Dominik
authors.initials: D
authors.lastname: Ettlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005157:Facial Pain / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D012647:Self-Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders / Q000209:etiology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult