Saugat Dileep, Mittal Asit, Vyas Kapil, Kaushik Pratap Bhan, Gupta Lalit, Maheshwari Kriti
Department of Dermatology, Venereology, and Leprosy, RNT Medical College, Udaipur, Rajasthan, India.
Department of Dermatology, Venereology and Leprosy, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
Indian Dermatol Online J. 2025 Feb 27;16(2):235-240. doi: 10.4103/idoj.idoj_835_23. eCollection 2025 Mar-Apr.
Currently available pruritus assessment tools may not always fulfill the needs of the Indian population and populations who share similar sociocultural backgrounds. To overcome this limitation, a new assessment tool "Pruritus Impact Scale (PIS)" was constructed and validated.
The primary objective is to construct and validate the novel PIS. The secondary objective is to evaluate the responsiveness of PIS to changes in symptoms.
This study design was cross-sectional for the primary objective and longitudinal for the secondary objective. The study recruited 435 patients of chronic pruritus of different etiologies for the construction of the PIS scale. Patients were asked to fill out four different pruritus measuring tools i.e., Numerical Rating Scale (NRS), Dermatology Life Quality Index (DLQI), 12-item Pruritus Severity Score (PSS), and newly constructed PIS. The PIS was derived from existing standard assessment tools with certain modifications to keep a balance of psychometric properties of the scale and the sociocultural needs of the population. The validity and reliability of the scale was assessed. For detecting the response of PIS to change in pruritus intensity, 276 patients were followed and were instructed to refill all four scales at 6 weeks from the baseline. The responsiveness was judged by comparing the mean score of all scales at baseline with the mean score at 6 weeks. In addition, the changes in the scores among all 4 scales were correlated and compared.
PIS showed strong internal consistency (Cronbach α = 0.882) and positively correlated with other validated pruritic tools such as NRS (ρ = 0.938, < 0.0001), DLQI (ρ = 0.914, < 0.01) and 12- PSS (ρ = 0.913, < 0.001) at baseline. PIS showed satisfactory reproducibility at 3-hour intervals (Cronbach α = 0.994). Responsiveness to change in pruritus as measured by PIS at 6 weeks reassessment was correlated well with the changes in NRS (ρ = 0.689, value < 0.0001), DLQI (ρ = 0.586, value < 0.0001) and 12-PSS (ρ = 0.928, value <0.0001).
A noteworthy limitation of the present study is the lack of comparison of different items (within a construct) comprised in different tools used for comparison.
The newly constructed PIS is a valid tool in the studied population.
目前可用的瘙痒评估工具可能并不总能满足印度人群以及具有相似社会文化背景人群的需求。为克服这一局限性，构建并验证了一种新的评估工具“瘙痒影响量表（PIS）”。
主要目的是构建并验证新型PIS。次要目的是评估PIS对症状变化的反应性。
本研究设计中，主要目的采用横断面研究，次要目的采用纵向研究。该研究招募了435名不同病因的慢性瘙痒患者以构建PIS量表。患者被要求填写四种不同的瘙痒测量工具，即数字评分量表（NRS）、皮肤病生活质量指数（DLQI）、12项瘙痒严重程度评分（PSS）以及新构建的PIS。PIS源自现有的标准评估工具，并进行了某些修改，以在量表的心理测量特性与人群的社会文化需求之间保持平衡。评估了该量表的有效性和可靠性。为检测PIS对瘙痒强度变化的反应，对276名患者进行了随访，并指示他们在基线后6周重新填写所有四种量表。通过比较所有量表在基线时的平均得分与6周时的平均得分来判断反应性。此外，对所有4种量表得分的变化进行了相关性分析和比较。
PIS显示出很强的内部一致性（Cronbach α = 0.882），并且在基线时与其他经过验证的瘙痒工具如NRS（ρ = 0.938，P < 0.0001）、DLQI（ρ = 0.914，P < 0.01）和12 - PSS（ρ = 0.913，P < 0.001）呈正相关。PIS在3小时间隔时显示出令人满意的可重复性（Cronbach α = 0.994）。在6周重新评估时，PIS所测量的对瘙痒变化的反应性与NRS的变化（ρ = 0.689，P值< 0.0001）、DLQI的变化（ρ = 0.586，P值< 0.0001）和12 - PSS的变化（ρ = 0.928，P值<0.0001）密切相关。
本研究一个值得注意的局限性是缺乏对用于比较的不同工具中所包含的不同项目（在一个结构内）的比较。
新构建的PIS在所研究的人群中是一种有效的工具。
