A PRISM-teszt papír-ceruza változatának alkalmazása a krónikus gerinceredetű fájdalom vizsgálatában.

Background: Spinal disorder related chronic pain is a multidimensional complex experience, for which standardised self-report and observational assessment tools are available. The advantage of the tests and symptom rating scales is that they can be used to specifically assess the determinants of pain experience, however, their administration is time consuming and their complexity can make them difficult, and therefore these instruments are subject to limitations in clinical use. Aim: In this study, we investigate how the PRISM (Pictorial Representation of Illness and Self Measure) projective drawing test can capture different dimensions of the pain experience and thus benefit clinical practice. Methods: 104 patients with chronic spinal pain, 38 male, 66 female, mean age 58 (SD=15.75) years, participated in the study. Results: Based on the results, two variables of the PRISM test, the SIS (i.e. the distance between the centre of the self-circle and the centre of the pain circle) and the variables created based on the localisation of the circles proved to be a useful tools to capture the relationships between pain and different psychological factors, while the IPM (i.e the area of the pain circle) was not useful in this case. Based on the quantitative data gathered from the PRISM test, the SIS shows a negative significant relationship with pain catastrophizing (rs = –0.24, p = 0.023), helplessness (rs = –0.27, p = 0.010), work-related fear-avoidance beliefs (rs = –0.21, p = 0.040), as well as depression (rs = –0.43, p < 0.000) and state- (rs = –0.35, p = 0.040) and trait-anxiety (rs = –0.23; p < 0.000). Besides, there was a significant difference between those whose pain-circle crossed their self-circle and those whose pain- and self-circle were separate, in terms of pain catastrophizing (Z = –2.432, U = 582.5, p = 0.015), rumination (Z = –2.249, U = 637.5, p = 0.025), helplessness (Z = –2.492 U = 577.5, p = 0.013), work- (Z = –2.404, U = 678.5, p = 0.016) and physical activity-related (Z = –1.961, U = 772.5, p = 0.050) and cumulative fear-avoidance beliefs (Z = –2.399, U = 643.5, p = 0.016), as well as depression (Z = –3.188, U = 640, p = 0.001) and trait-anxiety (Z = –2.592, U = 656.5, p = 0.010). Conclusions: The PRISM drawing test has been shown to capture relevant determinants of pain experience, from a treatment perspective, and can therefore be considered a clinically useful assessment procedure. In terms of its clinical applicability, the tool has been shown to identify patients who may benefit from comprehensive psychological assessment prior to somatic treatment. [ABSTRACT FROM AUTHOR]