Preliminary Validation of Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2): An Effective Tool for Assessing Suffering of Patients with Spinal Cord Injury in Mainland China

Abstract

Objectives: Patients with spinal cord injury (SCI) often have different degrees of psychological distress, which is related to the injury’s suddenness and the associated high level of disability. The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as a visual measure for assessing patients suffering from SCI. This study aimed to validate the effectiveness of PRISM-R2 in assessing the suffering of patients with SCI in Mainland China. Setting: Data were collected from hospitalized individuals with SCI at the Shanghai Yangzhi Rehabilitation Hospital (School of Medicine, Tongji University). Methods: The evaluation tools include: (1) The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2), (2) the World Health Organization Quality of Life Short Form Survey (WHOQOL-BREF), (3) the Multidimensional Body-Self Relations Questionnaire (MBSRQ), (4) the Patient Health Questionnaire-9 (PHQ-9), (5) the Social Support Rating Scale (SSRS), (6) the Numerical Rating Scale (NRS) and (7) the Modified Barthel Index (MBI). The validity of the PRISM-R2 content was also tested by content analysis. Results: The Self Illness Separation (SIS) and the Illness Perception Measure (IPM) showed a strong correlation (r = –0.54;p < 0.05). Qualitative data indicated that the interpretation of the PRISM-R2 task is not only consistent among patients, but it is consistent with that expected from existing literature on suffering. As expected, PRISM-R2 showed strong correlations with psychological variables (notably depression and social support, and appearance orientation) and also correlated with WHOQOL-BREF subscale scores. Conclusions: PRISM-R2 effectively reflects the perception of psychological variables and suffering in SCI patients and it may be beneficial in evaluating or guiding the intervention for people with SCI.