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Wang Y, Zhang C, Zhou Y. Reconstructing self from the illness: a constructivist grounded theory study of posttraumatic growth in patients with Crohn's disease. BMC Gastroenterol 2023; 23:244. [PMID: 37464276 DOI: 10.1186/s12876-023-02878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Some patients with Crohn's disease report posttraumatic growth, which can promote reductions in anxiety and depression, and improve the patient's quality of life. However, the process of posttraumatic growth remains unclear. The objectives of this study were to explore the social-psychological process of posttraumatic growth in patients with Crohn's disease in the context of Chinese culture and construct an interpretive understanding based on the perspectives of patients. METHODS This research adopted Charmaz's constructivist grounded theory. Nineteen participants with Crohn's disease were selected by purposive and theoretical sampling from three hospitals in Hangzhou, Zhejiang Province, as well as from the China Crohn's & Colitis Foundation. In-depth interviews were conducted. Data analysis was based on initial, focused and theoretical coding strategies, and methods such as constant comparison and memo writing were adopted. The Consolidated Criteria for Reporting Qualitative Research, a 32-item checklist for interviews and focus groups, was utilised. RESULTS An interpretive understanding of posttraumatic growth in patients with Crohn's disease was constructed. The core category was "reconstructing self from the illness", which included the following four categories: "suffering from the illness", "accepting the illness", "dancing with the illness" and "enriching life beyond the illness". However, not every patient reached the last phase. Before patients enter the next stage, they might begin a new cycle by experiencing new suffering or discovering new unacceptable facts about the illness. CONCLUSIONS This interpretive understanding reveals a growth process centred on "reconstructing self from the illness". These findings provide knowledge on the process of posttraumatic growth in patients with Crohn's disease within the wider sociocultural context.
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Affiliation(s)
- Ying Wang
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China
| | - Chen Zhang
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China.
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Ho S, Cook KV, Chen ZJ, Kurniati NMT, Suwartono C, Widyarini N, Wong PTP, Cowden RG. Suffering, psychological distress, and well-being in Indonesia: A prospective cohort study. Stress Health 2022; 38:879-890. [PMID: 35244330 PMCID: PMC10078741 DOI: 10.1002/smi.3139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/03/2022] [Accepted: 02/23/2022] [Indexed: 12/16/2022]
Abstract
Research on the subjective experience of suffering has typically focussed on older clinical samples living in Western, educated, industrialised, rich, and democratic (WEIRD) countries. To further extend the existing body of empirical research on suffering to less WEIRD contexts, we use three waves of data (Wave 1: December 2020; Wave 2: January 2021; Wave 3: February 2021) from a sample of nonclinical Indonesian adults (n = 594) to examine associations between suffering, two indices of psychological distress, and 10 facets of well-being. In our primary analysis, we estimated a series of multiple regression models that adjusted for a range of sociodemographic characteristics, financial and material stability, religious/spiritual factors, prior values of overall suffering, and prior values of each outcome assessed in Wave 1. Results indicated that overall suffering assessed in Wave 2 was associated with an increase in both indices of psychological distress and a decrease in eight facets of well-being assessed in Wave 3. Using a similar analytic approach, results from a secondary analysis indicated that higher scores on both indices of psychological distress and lower scores on seven of the well-being facets assessed in Wave 2 were associated with worse subsequent overall suffering assessed in Wave 3. These findings contribute to empirical literature on the implications of suffering for well-being.
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Affiliation(s)
- Samuel Ho
- Human Flourishing Program, Harvard University, Cambridge, Massachusetts, USA
| | - Kaye V Cook
- Department of Psychology, Gordon College, Wenham, Massachusetts, USA
| | - Zhuo Job Chen
- School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | | | - Christiany Suwartono
- Faculty of Psychology, Atma Jaya Catholic University of Indonesia, South Jakarta, Indonesia
| | - Nilam Widyarini
- Department of Psychology, Gunadarma University, Depok, Indonesia
| | - Paul T P Wong
- Department of Psychology, Trent University, Peterborough, Ontario, Canada
| | - Richard G Cowden
- Human Flourishing Program, Harvard University, Cambridge, Massachusetts, USA
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Sensky T. Mental Pain and Suffering: The "Universal Currencies" of the Illness Experience? PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:337-344. [PMID: 32781446 DOI: 10.1159/000509587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Tom Sensky
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom,
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Huangfu Z. Life course changes provoked by chronic disease: A study on everyday life for patients with systemic lupus erythematosus. Int J Nurs Sci 2020; 7:S31-S37. [PMID: 32995377 PMCID: PMC7501471 DOI: 10.1016/j.ijnss.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/28/2020] [Accepted: 05/18/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study examined patients with systemic lupus erythematosus (SLE) as a means to explore the impacts of chronic disease on life courses. METHODS A semi-structured in-depth interviews were conducted with nine patients in China in 2017; participants were included based on their having or having had facial butterfly erythema. RESULTS The study focused on both the disease's impact on the patients' health and on their daily lives. Four core themes emerged: visible changes in the patient's bodies, social dilemmas, "the encouragement of disease", and a new perspective on the relationship between disease and health. One important finding was that the occurrence of a chronic disease did not have only negative repercussions; some patients felt that there were advantages to being sick. Chronic disease resulted in a reworking of daily life. The patients developed a self-referential model of healing. CONCLUSION The distinct interpretations of the same disease offered by different patients served to yield a more complete understanding of the disease. People with SLE adjust their thinking about the disease based on personal feelings as well as experiences and pursue a dialogue on their illness based on the disease pattern unique to them. The meaning that disease had for the patients was not limited to negative connotations.
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Affiliation(s)
- Zheng Huangfu
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macau
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Wang Y, Fan S, Wang H, Li L, Jia Y, Chai L. Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2): an effective tool to assess perceived burden of thyroid cancer in mainland China. Support Care Cancer 2018; 26:3267-3275. [PMID: 29644472 PMCID: PMC6096532 DOI: 10.1007/s00520-018-4172-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/20/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Thyroid cancer, especially differentiated thyroid cancer (DTC), is a highly prevalent chronic disease that is known to cause considerable distress, related both to the high recurrence and treatment of the disease. The Pictorial Representation of Illness and Self Measure-Revised 2 (PRISM-R2) has been developed as a visual measure to assess suffering. The aim of this study was to evaluate the ability of the instrument to identify patients with DTC with different levels of suffering who may need additional support care. METHODS Participants were 338 adult inpatients with DTC who were accepting the radioiodine for remnant ablation in the nuclear medicine department. The assessment tools included the following: (1) the PRISM-R2, yielding Self-Illness Separation (SIS) and Illness Perception Measure (IPM); (2) distress thermometer (DT), a measure of thyroid cancer-related distress; (3) posttraumatic growth inventory (PTGI); (4) 12-item Short-Form health survey (SF-12); and (5) the Supportive Care Needs Survey Short Form (SCNS-SF34). In addition, the content validity of PRISM-R2 was tested using the patients' comments. RESULTS SIS and IPM showed medium intercorrelation (r = -.482; p < 0.01), and both of them showed strongly significant associations with DT. SIS also showed significant correlations with one factor of PTGI (personal strength), four factors of SF-12 (general health, role-emotional, mental health, and vitality), and one factor of SCNS-SF34 (psychological needs). IPM showed significant correlations with five factors of SF-12 and all the factors of SCNS-SF34. No correlation was found between IPM and PTGI. CONCLUSIONS PRISM-R2 is a well-accepted and understandable tool to assess the psychological burden of patients with thyroid cancer in Chinese settings. It may be useful to guide or evaluate the interventions for the patients.
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Affiliation(s)
- Yanbo Wang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Division of Medical Humanities & Behavioral sciences, Tongji University School of Medicine, Shanghai, China
| | - Suyun Fan
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Hongbiao Wang
- Sport Psychology Division, Sport Science College, Shenyang Sport University, Shenyang, China
| | - Li Li
- Department of Head, Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyan Jia
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Chai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Bustan S, Gonzalez-Roldan AM, Schommer C, Kamping S, Löffler M, Brunner M, Flor H, Anton F. Psychological, cognitive factors and contextual influences in pain and pain-related suffering as revealed by a combined qualitative and quantitative assessment approach. PLoS One 2018; 13:e0199814. [PMID: 30063704 PMCID: PMC6067693 DOI: 10.1371/journal.pone.0199814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/14/2018] [Indexed: 11/18/2022] Open
Abstract
Previous psychophysiological research suggests that pain measurement needs to go beyond the assessment of Pain Intensity and Unpleasantness by adding the evaluation of Pain-Related Suffering. Based on this three-dimensional approach, we attempted to elucidate who is more likely to suffer by identifying reasons that may lead individuals to report Pain and Pain-Related Suffering more than others. A sample of 24 healthy participants (age range 18-33) underwent four different sessions involving the evaluation of experimentally induced phasic and tonic pain. We applied two decision tree models to identify variables (selected from psychological questionnaires regarding pain and descriptors from post-session interviews) that provided a qualitative characterization of the degrees of Pain Intensity, Unpleasantness and Suffering and assessed the respective impact of contextual influences. The overall classification accuracy of the decision trees was 75% for Intensity, 77% for Unpleasantness and 78% for Pain-Related Suffering. The reporting of suffering was predominantly associated with fear of pain and active cognitive coping strategies, pain intensity with bodily competence conveying strength and resistance and unpleasantness with the degree of fear of pain and catastrophizing. These results indicate that the appraisal of the three pain dimensions was largely determined by stable psychological constructs. They also suggest that individuals manifesting higher active coping strategies may suffer less despite enhanced pain and those who fear pain may suffer even under low pain. The second decision tree model revealed that suffering did not depend on pain alone, but that the complex rating-related decision making can be shifted by situational factors (context, emotional and cognitive). The impact of coping and fear of pain on individual Pain-Related Suffering may highlight the importance of improving cognitive coping strategies in clinical settings.
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Affiliation(s)
- Smadar Bustan
- INSERM U-987, CHU « Pathophysiology and Clinical Pharmacology of Pain» Hospital Ambroise Paré, Boulogne-Billancourt, France
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Institute for Health and Behavior, FLSHASE/INSIDE, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- * E-mail:
| | - Ana Maria Gonzalez-Roldan
- Institute for Health and Behavior, FLSHASE/INSIDE, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Christoph Schommer
- ILIAS Laboratory, Dept. of Computer Science and Communication, FSTC, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Sandra Kamping
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Martin Löffler
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Brunner
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fernand Anton
- Institute for Health and Behavior, FLSHASE/INSIDE, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Larsen JL, Hall EOC, Jacobsen S, Birkelund R. The existential experience of everyday life with systemic lupus erythematosus. J Adv Nurs 2018; 74:1170-1179. [PMID: 29350776 DOI: 10.1111/jan.13525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/19/2023]
Abstract
AIM To explore from the perspective of women the nature of basic existential conditions while living with systemic lupus erythematosus. BACKGROUND Systemic lupus erythematosus has an unpredictable disease course and is documented to cause an existential rearrangement of life. The significance of changes in existential conditions and related experiences are unclear in the context of nursing and women with systemic lupus erythematosus. DESIGN A qualitative design guided by Van Manen's hermeneutic-phenomenological methodology. METHOD Individual in-depth interviews with 15 women diagnosed with systemic lupus erythematosus and of various ages, disease durations and severities were undertaken from September 2013 - October 2015. Data were analysed following van Manen's phenomenological approach and using drawing as an interpretive tool. FINDINGS The main existential experience was interpreted as a person "moving with the waves of systemic lupus erythematosus" constituted by the themes "oscillating between presence and absence of systemic lupus erythematosus," "recognizing space and bodily possibilities and limitations" and "being enriched through relationships and activities." When systemic lupus erythematosus was flaring, well-being was threatened and a laborious time to escape the feeling of a setback-in-life persisted long after the disease was medically under control. CONCLUSION Daily life with systemic lupus erythematosus is conditioned by a prominent need to be in existential motion, related to the absence and presence of systemic lupus erythematosus. The experience of a setback-in-life by illness might challenge well-being and indicates that periods of disease flares or disturbing symptoms are critical time points to provide support.
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Affiliation(s)
- Janni Lisander Larsen
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark.,Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth O C Hall
- Nursing Section, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Rheumatology and Spine Diseases Centre, Rigshospitalet, Copenhagen, Denmark
| | - Regner Birkelund
- Denmark & Lillebaelt Hospital, Institute of Regional Health Research, University of Southern, Vejle, Denmark
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8
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Larsen JL, Hall EO, Jacobsen S, Birkelund R. Being in a standstill-of-life: women's experience of being diagnosed with systemic lupus erythematosus: a hermeneutic-phenomenological study. Scand J Caring Sci 2017; 32:654-662. [DOI: 10.1111/scs.12491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 05/03/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Janni Lisander Larsen
- Section of Nursing; Department of Public Health; Aarhus University; Aarhus Denmark
- Copenhagen Lupus and Vasculitis Clinic; Rheumatology and Spine Diseases Centre; Rigshospitalet; Copenhagen Denmark
| | - Elisabeth O.C. Hall
- Section of Nursing; Department of Public Health; Aarhus University; Aarhus Denmark
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic; Rheumatology and Spine Diseases Centre; Rigshospitalet; Copenhagen Denmark
| | - Regner Birkelund
- Institute of Regional Health Research; University of Southern Denmark & Lillebaelt Hospital; Vejle Denmark
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The Use of PRISM (Pictorial Representation of Illness and Self Measure) in Patients Affected by Chronic Cutaneous Ulcers. Adv Skin Wound Care 2017; 28:489-94. [PMID: 26479691 DOI: 10.1097/01.asw.0000471977.92623.65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE PRISM (Pictorial Representation of Illness and Self Measure) is a nonverbal visualization instrument. The authors chose to use this tool to avoid the limitation of the other tests for the assessment of quality of life by using interview methods that depend on the cognitive and cultural level of the patient. The aim of the study was to assess the impact on the quality of life of different types of chronic wounds using the PRISM test. SETTING The PRISM test was administered by the same medical student to each patient visiting the dermatology department for a routine visit and medication. PARTICIPANTS The PRISM test was administered to 77 patients with chronic cutaneous ulcers referred to the Dermatology Department of the Spedali Civili of Brescia, Italy. MATERIALS AND METHODS The authors analyzed the "Self-llness-Separation"' (SIS) value, which resulted from the PRISM test, and related it to sex, age, and ulcer etiology. RESULTS Considering all categories, the mean SIS was 9.58 cm; a different perception of the disease between the sexes was noted and also in the subgroups based on the ulcer's different etiology. In addition, the age of the affected patients influenced the SIS value. CONCLUSIONS PRISM is an easy and sensitive instrument to record information about the patient's expectations and suffering in order to improve the overall physician-patient relationship.
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Marinello E, Linder D, Spoto A, Palmer K, Rohrer PM, Büchi S, Trapp M, Trapp EM, Hoerlesberger N, Piaserico S, Peserico A, Gatta M, Belloni Fortina A. Assessing the Impact of Atopic Dermatitis on the Patients' Parents with the Visual Instrument 'Caregiver-PRISM'. Dermatology 2016; 232:490-5. [PMID: 27560830 DOI: 10.1159/000448030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/10/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is a need to improve the quality of communication between clinicians and parents of young patients with atopic eczema (AE). OBJECTIVE To create a tool to measure the suffering that caregivers experience in association with their child's AE (Caregiver Pictorial Representation of Illness and Self-Measure, Caregiver-PRISM), assess the validity and reliability, and identify factors associated with caregiver suffering. METHODS Caregiver-PRISM was administered to 45 parents of patients from an AE outpatient service (Padua, Italy). RESULTS Caregiver-PRISM had a good test-retest reliability (r = 0.85; t7 = 4.13; p < 0.05), content validity and construct validity when used in parents of AE children. Parents with a less positive family affective climate, higher education, or with children following a diet experienced higher suffering associated with their child's AE, demonstrated by lower Caregiver-PRISM scores (p < 0.05). CONCLUSION Our results support the use of Caregiver-PRISM in parents of AE patients to assess suffering associated with patients' illness.
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Sensky T, Büchi S. PRISM, a Novel Visual Metaphor Measuring Personally Salient Appraisals, Attitudes and Decision-Making: Qualitative Evidence Synthesis. PLoS One 2016; 11:e0156284. [PMID: 27214024 PMCID: PMC4877057 DOI: 10.1371/journal.pone.0156284] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 05/11/2016] [Indexed: 11/28/2022] Open
Abstract
Background PRISM (the Pictorial Representation of Illness and Self Measure) is a novel, simple visual instrument. Its utility was initially discovered serendipitously, but has been validated as a quantitative measure of suffering. Recently, new applications for different purposes, even in non-health settings, have encouraged further exploration of how PRISM works, and how it might be applied. This review will summarise the results to date from applications of PRISM and propose a generic conceptualisation of how PRISM works which is consistent with all these applications. Methods A systematic review, in the form of a qualitative evidence synthesis, was carried out of all available published data on PRISM. Results Fifty-two publications were identified, with a total of 8254 participants. Facilitated by simple instructions, PRISM has been used with patient groups in a variety of settings and cultures. As a measure of suffering, PRISM has, with few exceptions, behaved as expected according to Eric Cassell’s seminal conceptualisation of suffering. PRISM has also been used to assess beliefs about or attitudes to stressful working conditions, interpersonal relations, alcohol consumption, and suicide, amongst others. Discussion This review supports PRISM behaving as a visual metaphor of the relationship of objects (eg ‘my illness’) to a subject (eg ‘myself’) in a defined context (eg ‘my life at the moment’). As a visual metaphor, it is quick to complete and yields personally salient information. PRISM is likely to have wide applications in assessing beliefs, attitudes, and decision-making, because of its properties, and because it yields both quantitative and qualitative data. In medicine, it can serve as a generic patient-reported outcome measure. It can serve as a tool for representational guidance, can be applied to developing strategies visually, and is likely to have applications in coaching, psychological assessment and therapeutic interventions.
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Affiliation(s)
- Tom Sensky
- Centre for Mental Health, Department of Medicine, Imperial College London, London, United Kingdom
- * E-mail:
| | - Stefan Büchi
- Clinic for Psychotherapy and Psychosomatics “Hohenegg”, Meilen, Switzerland
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Peter N, Kleinjung T, Horat L, Schmidt-Weitmann S, Meyer M, Büchi S, Weidt S. Validation of PRISM (Pictorial Representation of Illness and Self Measure) as a novel visual assessment tool for the burden of suffering in tinnitus patients. Health Qual Life Outcomes 2016; 14:47. [PMID: 27001548 PMCID: PMC4802891 DOI: 10.1186/s12955-016-0454-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 03/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Chronic subjective tinnitus is a frequent condition that affects the subject’s quality of life. The lack of objective measures of tinnitus necessitates the use of self-reporting and often time-consuming questionnaires for evaluating tinnitus severity. The Pictorial Representation of Illness and Self Measure (PRISM) is a two dimensional pictorial method to assess the burden of suffering. Patients illustrate their burden of suffering by the distance from a “self” to an illness circle, whereby a shorter distance indicates a higher burden of suffering. The aim of this prospective observational study was to validate the burden of suffering measured with PRISM in tinnitus patients by comparing it with different standardized questionnaires currently used in tinnitus evaluation. Methods A total of 188 patients filled out an online-based survey including sociodemographic variables and the following questionnaires: Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), WHO Quality of Life-Questionnaire (WHOQOL-BREF), and the Beck Depression Inventory (BDI). The subtle differences in the burden of suffering were accessed by using PRISM as an iPad version. Based on PRISM performance patients could easily be assigned in three groups, these being mildly, moderately, or severely affected akin to the standard questionnaires. Results The burden of suffering measured with PRISM correlated with the tinnitus severity (THI and TQ), depressive symptoms (BDI), and health related quality of life (WHOQOL-BREF) (all p ≤ 0.001). In the three PRISM groups tinnitus severity (THI and TQ), and depressive symptoms (BDI) differed significantly (all p ≤ 0.01). Conclusion PRISM is an easily understood and time saving method for the assessment of burden of suffering in tinnitus patients. In daily clinical practice PRISM can help to identify patients with decompensated tinnitus that require more intensive treatment.
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Affiliation(s)
- Nicole Peter
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland.
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland
| | - Lukas Horat
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland
| | | | - Martin Meyer
- Psychological Institute, University of Zurich, Zurich, Switzerland
| | - Stefan Büchi
- Clinic for Psychotherapy and Psychosomatics "Hohenegg", Meilen, Switzerland
| | - Steffi Weidt
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
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Alves VLP, Carniel AQ, Costallat LTL, Turato ER. Meanings of the sickening process for patients with systemic lupus erythematosus: a review of the literature. REVISTA BRASILEIRA DE REUMATOLOGIA 2014; 55:522-7. [PMID: 25440711 DOI: 10.1016/j.rbr.2014.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 07/12/2014] [Accepted: 08/26/2014] [Indexed: 12/22/2022] Open
Abstract
Systemic lupus erythematosus is an autoimmune disease that causes many psychological repercussions that have been studied through qualitative research. These are considered relevant, since they reveal the amplitude experienced by patients. Given this importance, this study aims to map the qualitative production in this theme, derived from studies of experiences of adult patients of both genders and that had used as a tool a semi-structured interview and/or field observations, and had made use of a sampling by a saturation criterion to determine the number of participants in each study. The survey was conducted in Pubmed, Lilacs, Psycinfo e Cochrane databases, searching productions in English and Portuguese idioms published between January 2005 and June 2012. The 19 revised papers that have dealt with patients in the acute phase of the disease showed themes that were categorized into eight topics that contemplated the experienced process at various stages, from the onset of the disease, extending through the knowledge of the diagnosis and the understanding of the manifestations of the disease, drug treatment and general care, evolution and prognosis. The collected papers also point to the difficulty of understanding, of the patients, on what consists the remission phase, revealing also that this is a clinical stage underexplored by psychological studies.
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Sutanto B, Singh-Grewal D, McNeil HP, O'Neill S, Craig JC, Jones J, Tong A. Experiences and Perspectives of Adults Living With Systemic Lupus Erythematosus: Thematic Synthesis of Qualitative Studies. Arthritis Care Res (Hoboken) 2013; 65:1752-65. [DOI: 10.1002/acr.22032] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/03/2013] [Accepted: 04/10/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Bernadet Sutanto
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
| | - Davinder Singh-Grewal
- University of Sydney, The Children's Hospital at Westmead, University of New South Wales, and Liverpool Hospital; Sydney, New South Wales Australia
| | - H. Patrick McNeil
- University of New South Wales and Liverpool Hospital; Sydney, New South Wales Australia
| | - Sean O'Neill
- University of New South Wales and Liverpool Hospital; Sydney, New South Wales Australia
| | - Jonathan C. Craig
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
| | - Julie Jones
- University of Sydney; Sydney, New South Wales Australia
| | - Allison Tong
- University of Sydney and The Children's Hospital at Westmead; Sydney, New South Wales Australia
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Assessing suffering in advanced cancer patients using Pictorial Representation of Illness and Self-Measure (PRISM), preliminary validation of the Spanish version in a Latin American population. Support Care Cancer 2013; 21:3327-36. [PMID: 23903801 DOI: 10.1007/s00520-013-1913-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE This study aims to adapt the Pictorial Representation of Illness and Self-Measure (PRISM), a practical, nonverbal method with strong psychometric properties, to Spanish and to explore its criterion validity in advanced cancer and palliative care (PC). METHODS Of the consecutive advanced cancer patients attending a palliative care consultation, 209 were invited to participate. To examine criterion validity, correlations were calculated between the PRISM, the Detection of Emotional Distress scale (DED), the Edmonton Symptom Assessment System (ESAS), the Structured Interview of Symptoms and Concerns (SISC), and the suffering visual analogue scale (VAS). RESULTS Ninety-eight patients fulfilled inclusion criteria (mean age, 60 years; SD, 14.25; 57 % female). The most frequent types of cancer were lung, breast, and colorectal. Average time since diagnosis was 30 months (2.5 years). PRISM significantly correlated with the Suffering VAS, the DED, and the SISC. It also showed significant correlations with psychosocial factors such as emotional distress, anxiety, loss of control, and perceived coping and spiritual distress items such as loss of dignity and hopelessness, but not with items examining physical symptoms. CONCLUSIONS The PRISM is a valid measure of suffering in advanced cancer patients. Its Spanish version fits adequately with current definitions and conceptualizations of suffering and may be used in PC settings. Further analysis of other psychometric properties in Spanish-speaking settings is recommended.
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Krikorian A, Limonero JT, Corey MT. Suffering assessment: a review of available instruments for use in palliative care. J Palliat Med 2013; 16:130-42. [PMID: 23350831 DOI: 10.1089/jpm.2012.0370] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The prevention and relief of suffering in palliative care are critical to the well-being and quality of life of patients and families facing life-threatening diseases. Many tools to assess different issues in health care are available, but few are specifically designed to evaluate suffering, which is essential for its prevention, early management, and treatment. OBJECTIVE The purpose of this review was to identify and describe existing instruments developed to assess suffering in palliative care, as well as to comment on their psychometric properties. METHODS A review of articles indexed in MEDLINE, PsycINFO, and SciELO up to June 2011 was conducted. All articles reporting the development, description, or psychometric properties of instruments that assess suffering were included. An assessment of their psychometric quality was performed following a structured checklist. RESULTS Ten instruments that assess suffering were identified. Their main features and psychometric properties are described in order to facilitate the selection of the appropriate one given each patient's context. CONCLUSION By taking into consideration all features of the assessment instruments under review, the evaluation of suffering can be made easier. A wide and ever expanding range of approaches is now available, which facilitates the selection of the suffering-assessment instrument that is best suited to the needs of the specific patient. One of the challenges ahead will be to further analyze the psychometric properties of some existing instruments.
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Affiliation(s)
- Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia.
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17
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Clara Vélez M, Palacio C, Isabel Moreno A, Krikorian A. Psychological and family-related facts of suffering in patients with chronic diseases. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.trap.2013.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mattsson M, Möller B, Stamm T, Gard G, Boström C. Uncertainty and opportunities in patients with established systemic lupus erythematosus: a qualitative study. Musculoskeletal Care 2012; 10:1-12. [PMID: 22009870 DOI: 10.1002/msc.220] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Systemic lupus erythematosus (SLE) is a chronic disease which can affect any organ, and the impact of the condition will affect each person differently. There are few qualitative studies including the experiences of both women and men with a diagnosis of SLE corresponding to the American College of Rheumatology (ACR) criteria where both negative and positive impacts of the disease have been presented. PURPOSE The aim was to describe how patients with established SLE experience their illness in everyday life, including both negative and positive aspects. METHOD Four focus group interviews were conducted with 16 women and three men with SLE according to ACR criteria, with varied disease activity and no or little organ damage. The interviews were tape recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS Two themes emerged: multifaceted uncertainty contained the categories 'an unreliable body', 'obtrusive pain and incomprehensible fatigue', 'mood changes and worries', 'reliance on medication and health care'; Focus on health and opportunities included 'learning process implying personal strength', 'limitations and possibilities in activities and work', 'a challenge to explain and receive support' and 'living an ordinary life incorporating meaningful occupations'. CONCLUSIONS While we expected to find a mainly negative impact, positive aspects were also described. Our findings were complex and showed that patients with established SLE can experience both uncertainty and opportunities. This highlights the importance for healthcare professionals of gaining a better understanding of patients' uncertainty, to enable them to support patients, allowing them to focus on health and opportunities. Measurement instruments that capture different aspects of uncertainty and opportunities needs to be developed.
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Affiliation(s)
- M Mattsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
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Krikorian A, Limonero JT, Maté J. Suffering and distress at the end-of-life. Psychooncology 2011; 21:799-808. [DOI: 10.1002/pon.2087] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 09/09/2011] [Accepted: 09/20/2011] [Indexed: 11/07/2022]
Affiliation(s)
| | - Joaquín T. Limonero
- Research Group on Stress and Health, Faculty of Psychology; Universidad Autónoma de Barcelona; Barcelona; Spain
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20
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Mazzoni D, Cicognani E. Social support and health in patients with systemic lupus erythematosus: A literature review. Lupus 2011; 20:1117-25. [DOI: 10.1177/0961203311412994] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the last decades, with the improvement of life expectancies for systemic lupus erythematosus (SLE) patients, the relationship between social support and health in this population has received a considerable amount of attention in behavioural medicine and health psychology. This paper is the first to review research studies which specifically investigated perceived social support in relation to SLE patients’ health outcomes (quality of life, disease activity and damage). Starting with a descriptive approach to social support perceived by patients with SLE, the research evidence on the impact of social support on health is presented. These studies demonstrate that the consideration of social support is critical in predicting disease activity, damage and quality of life (both physical and psychological components) although the precise ways in which social support contributes to health are not yet completely understood. Discussing the results, the authors offer some suggestions which could guide further research in this field. Finally, clinical and non-clinical implications of the findings are discussed.
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Affiliation(s)
- D Mazzoni
- Department of Education Sciences, University of Bologna, Italy
| | - E Cicognani
- Department of Education Sciences, University of Bologna, Italy
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22
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Personal transformation in chronic physical disease: Conceptual limitations of the posttraumatic growth construct. PSIHOLOGIJA 2010. [DOI: 10.2298/psi1004375w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This quantitative-qualitative case study focuses on processes of personal
transformation in chronic physical disease in order to further our
understanding of the posttraumatic growth construct. Semistructured
interviews were conducted with women suffering from Systemic Lupus
Erythematosus. The validity of the posttraumatic growth construct is assessed
comparing results obtained by a standardized measure (Posttraumatic Growth
Inventory) to individual pictorial and verbal depictions of personal
transformation processes. Detailed examinations of three cases evidenced the
validity of subjective appraisals of posttraumatic growth. Also, the
Posttraumatic Growth Inventory covered all facets of positive growth
processes as portrayed by individual depictions. However, the concept of
posttraumatic growth neglects negatively evaluated processes of personal
transformation. The consequences of this conceptual bias are discussed with
respect to clinical care as well as contradictory results seen in empirical
research. Posttraumatic loss and destruction is suggested as a second
dimension for the representation of personal transformation in chronic
physical disease.
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