Büchi Stefan, Buddeberg Claus, Klaghofer Richard, Russi Erich W, Brändli Otto, Schlösser Corinne, Stoll Thomas, Villiger Peter M, Sensky Tom
Psychiatric Department, University Hospital Zürich, Switzerland.
Psychother Psychosom. 2002 Nov-Dec;71(6):333-41. doi: 10.1159/000065994.
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.
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.
Validity and reliability studies to date have involved over 700 patients with a variety of chronic physical illnesses.
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.
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.
减轻痛苦被广泛认为是医学的主要目标之一。然而，迄今为止尚未开发出评估疾病这一关键方面的方法。
验证PRISM（疾病与自我测量的图形表示法）作为一种评估疾病所致痛苦感知负担的简单定量方法。
迄今为止的效度和信度研究涉及700多名患有各种慢性躯体疾病的患者。
PRISM的信度良好（重测信度r = 0.95；p≤0.001，评分者间信度r = 0.79；p≤0.001）。定性数据表明，PRISM任务的解释不仅在患者之间是一致的，而且与现有关于痛苦的文献预期一致。正如预期的那样，PRISM与心理变量（特别是抑郁和应对复原力）有很强的相关性，并且也与SF - 36分量表得分相关。前瞻性纵向数据表明，PRISM对治疗变化敏感。患者对其接受度很高，实施时间不到5分钟。
在缺乏痛苦的“金标准”测量方法的情况下，我们的验证数据必须谨慎解释。然而，基于目前已发表的研究，PRISM的表现与对痛苦测量方法的预期完全一致。
