title: Suffering in long-term cancer survivors: an evaluation of the PRISM-R2 in a population-based cohort.
abstract: OBJECTIVE
  The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as generic measure to assess suffering. The aim of this study was to evaluate the ability of this instrument to identify long-term cancer survivors with high levels of suffering who may need additional support.
  
  
  METHODS
  1299 cancer survivors completed the PRISM-R2, the Short Form Health Survey (SF-36), and the Quality of Life-Cancer Survivors questionnaire (QoL-CS). The PRISM-R2 distinguishes between the Self-Illness Separation (SIS) and Illness Perception Measure (IPM), both measuring aspects of suffering.
  
  
  RESULTS
  112 (9%) cancer survivors reported high suffering according to IPM. This group had a higher cancer stage at diagnosis, more cancer recurrences, more comorbidities, and were lower educated compared to people reporting less suffering. The PRISM-R2 could explain substantial amounts of variance (10-14%) in the psychological aspects of the SF-36 and QoL-CS. The IPM also discriminated statistically and clinically significant between high- and low-health status.
  
  
  CONCLUSIONS
  The PRISM-R2 proved to be able to discriminate between individuals with good and deteriorated levels of QoL. Further evaluation of its validity and screening potential is recommended.
authors.affiliation: Department of Medical Psychology and Neuropsychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands.
authors.forename: Vicky
authors.initials: V
authors.lastname: Lehmann
authors.forename: Simone
authors.initials: S
authors.lastname: Oerlemans
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
authors.forename: Ad J J M
authors.initials: AJ
authors.lastname: Vingerhoets
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000368:Aged; D000704:Analysis of Variance; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009426:Netherlands; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D055815:Young Adult