Stubbing D G, Haalboom P, Barr P
Department of Medicine, Hamilton Health Sciences Corporation, Ontario, Canada.
J Cardiopulm Rehabil. 1998 Jan-Feb;18(1):32-6. doi: 10.1097/00008483-199801000-00004.
The study assessed the value of the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) in determining the psychosocial impact of impairment and disability in patients with chronic irreversible airflow limitation.
Fifty-six consecutive patients admitted to respiratory rehabilitation were studied. Psychosocial adjustment was measured with the PAIS-SR and was judged separately by two health-care workers on the rehabilitation team. Agreement between the PAIS-SR and the health-care workers was determined using the Kappa statistic.
Four subjects did not complete the questionnaire. The data from 52 subjects were analyzed. The mean forced expired volume in one second (FEV1) was 1.2 +/- 0.4 L. The mean age was 66.4 +/- 9.0 years. There was good agreement between the individual assessment of each health-care worker (P < 0.001). There was good agreement between the score on the PAIS-SR and the clinical assessment by each of the health-care workers (P < 0.001). However, there were 10 subjects who identified severe adjustment difficulties that were not recognized by the health-care professionals.
Although there was agreement between the PAIS-SR and clinical judgment in assessing the psychosocial impact impairment and disability in chronic airflow limitation, the PAIS-SR may identify individuals with adjustment difficulties not recognized by members of the health-care team. The results support the routine use of objective measures to assess the psychosocial impact of chronic airflow limitation.
本研究评估了疾病心理社会适应量表-自我报告（PAIS-SR）在确定慢性不可逆气流受限患者损伤和残疾的心理社会影响方面的价值。
对连续收治的56例呼吸康复患者进行研究。使用PAIS-SR测量心理社会适应情况，并由康复团队中的两名医护人员分别进行判断。使用Kappa统计量确定PAIS-SR与医护人员之间的一致性。
4名受试者未完成问卷。对52名受试者的数据进行了分析。一秒用力呼气容积（FEV1）的平均值为1.2±0.4L。平均年龄为66.4±9.0岁。每位医护人员的个体评估之间具有良好的一致性（P<0.001）。PAIS-SR得分与每位医护人员的临床评估之间具有良好的一致性（P<0.001）。然而，有10名受试者存在严重的适应困难，而医护专业人员并未识别出来。
尽管在评估慢性气流受限患者的心理社会影响损伤和残疾方面，PAIS-SR与临床判断之间存在一致性，但PAIS-SR可能识别出医护团队成员未识别出的有适应困难的个体。结果支持常规使用客观测量方法来评估慢性气流受限的心理社会影响。
