Suffering in long-term cancer survivors: An evaluation of the PRISM-R2 in a population-based cohortReportar como inadecuado

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Quality of Life Research

, Volume 20, Issue 10, pp 1645–1654

First Online: 16 April 2011Accepted: 30 March 2011


PurposeThe Pictorial Representation of Illness and Self Measure-Revised 2 PRISM-R2 has been developed as generic measure to assess suffering. The aim of this study was to evaluate the ability of this instrument to identify long-term cancer survivors with high levels of suffering who may need additional support.

Methods1299 cancer survivors completed the PRISM-R2, the Short Form Health Survey SF-36, and the Quality of Life-Cancer Survivors questionnaire QoL-CS. The PRISM-R2 distinguishes between the Self-Illness Separation SIS and Illness Perception Measure IPM, both measuring aspects of suffering.

Results112 9% cancer survivors reported high suffering according to IPM. This group had a higher cancer stage at diagnosis, more cancer recurrences, more comorbidities, and were lower educated compared to people reporting less suffering. The PRISM-R2 could explain substantial amounts of variance 10–14% in the psychological aspects of the SF-36 and QoL-CS. The IPM also discriminated statistically and clinically significant between high- and low-health status.

ConclusionThe PRISM-R2 proved to be able to discriminate between individuals with good and deteriorated levels of QoL. Further evaluation of its validity and screening potential is recommended.

KeywordsOncology Survivors PRISM-R2 Suffering Quality of life AbbreviationsANOVAAnalyses of variance

BPBodily pain

ECREindhoven Cancer Registry

GHGeneral health

IPMIllness Perception Measure

MHMental health

MCSMental component summary

PCSPhysical component summary

PRISMPictorial Representation of Illness and Self Measure

PRISM-R2Pictorial Representation of Illness and Self Measure-Revised 2

PFPhysical functioning

QoLQuality of Life

QoL-CSQuality of Life-Cancer Survivors questionnaire

RERole emotional functioning

RPRole physical functioning

SISSelf-Illness Separation

SF-36Short Form Health Survey

SFSocial functioning


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Autor: Vicky Lehmann - Simone Oerlemans - Lonneke V. van de Poll-Franse - Ad. J.J.M. Vingerhoets - Floortje Mols


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