title: Pictorial Representation of Illness and Self Measure (PRISM): A novel visual instrument to measure quality of life in dermatological inpatients.
abstract: OBJECTIVE
  To validate the PRISM (Pictorial Representation of Illness and Self Measure) tool, a novel visual instrument, for the assessment of health-related quality of life in dermatological inpatients compared with the Dermatology Life Quality Index (DLQI) and the Skindex-29 questionnaires and to report qualitative information on PRISM.
  
  
  METHODS
  In an open longitudinal study, PRISM and Skindex-29 and DLQI questionnaires were completed and HRQOL measurements compared.
  
  
  METHODS
  Academic dermatological inpatient ward.
  
  
  METHODS
  The study population comprised 227 sequential dermatological inpatients on admission.
  
  
  METHODS
  Patients completed the PRISM tool and the Skindex-29 and DLQI questionnaires at admission and discharge.
  
  
  METHODS
  PRISM Self-Illness Separation (SIS) score; Skindex-29 and DLQI scores; and qualitative PRISM information by Mayring inductive qualitative context analysis.
  
  
  RESULTS
  The PRISM scores correlated well with those from the Skindex-29 (rho = 0.426; P < .001) and DLQI (rho = 0.304; P < .001) questionnaires. Between PRISM and Skindex-29 scores, the highest correlations were for dermatitis (rho = 0.614) and leg ulcer (rho = 0.554), and between PRISM and DLQI scores, the highest correlations were for psoriasis (rho = 0.418) and tumor (rho = 0.399). The PRISM tool showed comparable or higher sensitivity than quality of life questionnaires to assess changes in the burden of suffering during hospitalization. Inductive qualitative context analysis revealed impairment of adjustment and self-image as major aspects. Patients overall expected symptomatic and functional improvement. In patients with psoriasis and leg ulcers, many expected no treatment benefit.
  
  
  CONCLUSIONS
  The PRISM tool proved to be convenient and reliable for health-related quality of life assessment, applicable for a wide range of skin diseases, and correlated with DLQI and Skindex-29 scores. With the PRISM tool, free-text answers allow for the assessment of individual information and potentially customized therapeutic approaches.
authors.affiliation: Department of Dermatology, University Hospital Zürich, Switzerland.
authors.forename: Beda
authors.initials: B
authors.lastname: Mühleisen
authors.forename: Stefan
authors.initials: S
authors.lastname: Büchi
authors.forename: Simone
authors.initials: S
authors.lastname: Schmidhauser
authors.forename: Josef
authors.initials: J
authors.lastname: Jenewein
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.forename: Günther F L
authors.initials: GF
authors.lastname: Hofbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012871:Skin Diseases; D011795:Surveys and Questionnaires; D055815:Young Adult