Comparison of the Psychosocial Adjustment to Illness Scale-Self Report and clinical judgment in patients with chronic lung disease.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.