The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain

Mitsunao Tomioka; Masako Hosoi; Tomona Okuzawa; Kozo Anno; Rie Iwaki; Hiroshi Kawata; Chiharu Kubo; Nobuyuki Sudo

doi:10.1186/s13030-021-00223-0

The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain

Biopsychosoc Med. 2021 Nov 20;15(1):22. doi: 10.1186/s13030-021-00223-0.

Authors

Mitsunao Tomioka¹, Masako Hosoi^{2

3

4}, Tomona Okuzawa⁵, Kozo Anno³, Rie Iwaki³, Hiroshi Kawata⁶, Chiharu Kubo⁷, Nobuyuki Sudo^{2

3

4}

Affiliations

¹ Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan. tomioka.mitsunao.553@m.kyushu-u.ac.jp.
² Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
³ Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
⁴ Multidisciplinary Pain Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
⁵ Center for Dementia Related-Diseases, Konan Medical Center, 1-5-16 Kamokogahara, Higashinada-ku, Kobe City, Hyogo, 658-0064, Japan.
⁶ Department of Psychosomatic Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, 3-23-1 Shiobaru, Minami-ku, Fukuoka City, Fukuoka, 815-8588, Japan.
⁷ Nakamura Gakuen University, 5-7-1 Befu, Jounan-ku, Fukuoka City, Fukuoka, 814-0198, Japan.

Abstract

Background: Pictorial Representation of Illness and Self Measure (PRISM) is a tool that can be used to visualize and evaluate the burden of suffering caused by an illness. The aim of this study was to identify which aspects of the burden of chronic pain patients are associated with Self/illness separation (SIS), an indicator of the magnitude of suffering. We also examined the effectiveness of PRISM for evaluating changes in the relationships between patients and their medical care and significant others due to our inpatient treatment.

Methods: Seventy-two patients with chronic pain who were outpatients or admitted to the Department of Psychosomatic Medicine completed PRISM, depression and anxiety scales, and three types of pain-related self-assessment questionnaires (Brief Pain Inventory, Short-form McGill Pain Questionnaire, and Pain Catastrophizing Scale). Outpatients were queried at the time of outpatient visits and inpatients at the time of admission. In addition to PRISM disks related to illness, we asked each patient to place disks related to things important to them and their medical care. Of the inpatients, 31 did PRISM at the time of discharge. Among the reported important factors, which significant other was placed at the time of admission and discharge was evaluated. The distances of self/medical care separation (SMcS) and self/significant others separation (SSoS) were measured.

Results: Of the 21 scales measured, 10 showed a significant correlation with SIS. Factor analysis of these 10 scales extracted three factors, Life interferences, Negative affects, and Pain intensity. The SMcS and SSoS distances were shorter at discharge than at admission.

Conclusions: PRISM for patients with chronic pain is an integrated evaluation method that reflects three aspects of pain. By adding medical care and significant others to the usual method of placing only illness on the sheet it became possible to assess changes in the quality of interpersonal relationships.

Keywords: Chronic pain; Patient/physician relationship; Patient/significant others relationship; Pictorial representation of illness and self measure.

Abstract

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