Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) – a novel method to assess perceived burden of illness in diabetes patients

<p>Abstract</p> <p>Background</p> <p>The Pictorial Representation of Illness and Self Measure (PRISM) has been introduced as a visual measure of suffering. We explored the validity of a revised version, the PRISM-RII, in diabetes patients as part of the annual review.</p> <p>Methods</p> <p>Participants were 308 adult outpatients with either type 1 or type 2 diabetes. Measures: (1) the PRISM-RII, yielding Self-Illness Separation (SIS) and Illness Perception Measure (IPM); (2) the Problem Areas in Diabetes (PAID) scale, a measure of diabetes-related distress; (3) the WHO-5 Well-Being Index; (4) and a validation question on suffering (SQ). In addition, patients' complication status, comorbidity and glycemic control values(HbA1c) were recorded.</p> <p>Results</p> <p>Patients with complications did have marginally significant higher scores on IPM, compared to patients without complications. Type 2 patients had higher IPM scores than Type 1 patients. SIS and IPM showed low intercorrelation (<it>r </it>= -.25; <it>p </it>< .01). Convergent validity of PRISM-RII was demonstrated by significant correlations between IPM and PAID (<it>r </it>= 0.50; <it>p </it>< 0.01), WHO-5 (<it>r </it>= -.26; <it>p </it>< 0.01) and SQ (<it>r </it>= 0.36; <it>p </it>< 0.01). SIS showed only significant correlations with PAID (<it>r </it>= -0.28; <it>p </it>< 0.01) and SQ (<it>r </it>= -0.22; <it>p </it>< 0.01). Neither IPM nor SIS was significantly associated with HbA1c. The PRISM-RII appeared easy to use and facilitated discussion with care providers on coping with the burden of diabetes.</p> <p>Conclusion</p> <p>PRISM-RII appears a promising additional tool to assess the psychological burden of diabetes.</p