Tomioka Mitsunao, Hosoi Masako, Okuzawa Tomona, Anno Kozo, Iwaki Rie, Kawata Hiroshi, Kubo Chiharu, Sudo Nobuyuki
Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
Biopsychosoc Med. 2021 Nov 20;15(1):22. doi: 10.1186/s13030-021-00223-0.
Pictorial Representation of Illness and Self Measure (PRISM) is a tool that can be used to visualize and evaluate the burden of suffering caused by an illness. The aim of this study was to identify which aspects of the burden of chronic pain patients are associated with Self/illness separation (SIS), an indicator of the magnitude of suffering. We also examined the effectiveness of PRISM for evaluating changes in the relationships between patients and their medical care and significant others due to our inpatient treatment.
Seventy-two patients with chronic pain who were outpatients or admitted to the Department of Psychosomatic Medicine completed PRISM, depression and anxiety scales, and three types of pain-related self-assessment questionnaires (Brief Pain Inventory, Short-form McGill Pain Questionnaire, and Pain Catastrophizing Scale). Outpatients were queried at the time of outpatient visits and inpatients at the time of admission. In addition to PRISM disks related to illness, we asked each patient to place disks related to things important to them and their medical care. Of the inpatients, 31 did PRISM at the time of discharge. Among the reported important factors, which significant other was placed at the time of admission and discharge was evaluated. The distances of self/medical care separation (SMcS) and self/significant others separation (SSoS) were measured.
Of the 21 scales measured, 10 showed a significant correlation with SIS. Factor analysis of these 10 scales extracted three factors, Life interferences, Negative affects, and Pain intensity. The SMcS and SSoS distances were shorter at discharge than at admission.
PRISM for patients with chronic pain is an integrated evaluation method that reflects three aspects of pain. By adding medical care and significant others to the usual method of placing only illness on the sheet it became possible to assess changes in the quality of interpersonal relationships.
疾病与自我测量的图形表示法（PRISM）是一种可用于直观呈现和评估疾病所致痛苦负担的工具。本研究的目的是确定慢性疼痛患者负担的哪些方面与自我/疾病分离（SIS）相关，SIS是痛苦程度的一个指标。我们还研究了PRISM在评估因住院治疗导致的患者与其医疗护理及重要他人之间关系变化方面的有效性。
72名慢性疼痛患者，包括门诊患者或身心医学科住院患者，完成了PRISM、抑郁和焦虑量表，以及三种与疼痛相关的自我评估问卷（简明疼痛问卷、简化版麦吉尔疼痛问卷和疼痛灾难化量表）。门诊患者在门诊就诊时接受询问，住院患者在入院时接受询问。除了与疾病相关的PRISM圆盘外，我们还要求每位患者放置与对他们及其医疗护理重要的事物相关的圆盘。在住院患者中，31人在出院时完成了PRISM。在报告的重要因素中，评估了入院和出院时放置的是哪位重要他人。测量了自我/医疗护理分离（SMcS）和自我/重要他人分离（SSoS）的距离。
在所测量的21个量表中，10个与SIS显示出显著相关性。对这10个量表进行因子分析提取出三个因子，即生活干扰、负面影响和疼痛强度。出院时的SMcS和SSoS距离比入院时短。
慢性疼痛患者的PRISM是一种反映疼痛三个方面的综合评估方法。通过在通常仅在图表上放置疾病的方法中加入医疗护理和重要他人，就有可能评估人际关系质量的变化。
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