Background: Health outcome is multi-faceted, and for both research and clinical practice, greater knowledge of its facets is required. The Pictorial Representation of Illness and Self Measure (PRISM) was developed as a simple, rapid measure of the current impact of illness and symptoms on the individual. Methods: The PRISM task was completed by 26 outpatients with rheumatoid arthritis participating in a larger study of psychosocial correlates of arthritis, which included assessment of disease variables, functional impairment, pain, depression and patients’ appraisals of their illness. In the PRISM task, the patient was asked to imagine that a small board represents his/her life and a fixed disk on the board represents his/her ‘self’. The task was to place another (Illness) disk on the board to represent the current importance of illness in the patients’ life. The main outcome measure was the distance between the Self and Illness disks. Findings: Only 2 patients had difficulty understanding the task. PRISM distance did not correlate with any disease variables. It correlated inversely with pain, functional impairment and depression, and positively with coping resources. PRISM distance correlated with perceived control over illness and negatively with awareness of illness. Interpretation: PRISM is an innovative measure, simple and well accepted by patients. It appears to measure what in German is termed leidensdruck, the burden of suffering due to illness. It offers a promising measure of an intangible but important health outcome, hitherto neglected, applicable to research interventions and clinical practice.
Dr. med. S. Büchi
Abteilung für Psychosoziale Medizin
Psychiatrische Poliklinik, Universitätsspital
CH–8091 Zürich (Switzerland)
Tel. + 41 1 255 51 27, Fax + 41 1 255 43 84, E-Mail email@example.com
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 19
Psychotherapy and Psychosomatics
Founded 1953 as ‘Acta Psychotherapeutica et Psychosomatica’ by E.A.D.E. Carp and B. Stokvis, continued by Th. Spoerri (1964–1974) and P.E. Sifneos (1974–1991)
Vol. 67, No. 4-5, Year 1998 (Cover Date: July-October 1998)
Journal Editor: G.A. Fava, Bologna
ISSN: 0033–3190 (print), 1423–0348 (Online)
For additional information: http://www.karger.com/journals/pps
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