Psychosocial Adjustment To Illness Scale-Self Report Research Articles

The effects of education based on the Roy adaptation model on medication adherence and psychosocial adjustment in hypertensive patients

Background and AimPatient education utilizing nursing theory can enhance patient adherence to treatment and potentially decrease mortality rates. The objective of this investigation was to assess the impact of Roy's adaptation Model-focused education on medication adherence and psychosocial compliance in hypertensive patients. MethodsThis study was conducted in N = 60 hypertensive patients (n = 30 control group and n = 30 experimental group) based on a randomized controlled trial design. In the pre-test phase of the study, data was collected using the Patient Information Form, the medication adherence rating scale (MARS), and the psychosocial adjustment to illness scale-self-report (PAIS-SR). After the pre-test phase, the experimental group received hypertension education and the “Hypertension Education Booklet” for a duration of four weeks. No education was provided to the control group patients; only routine follow-ups were conducted. In the post-test phase (after four weeks), both groups were reassessed using MARS and PAIS-SR. After completing the study, the control group patients who volunteered to participate in the education were provided with hypertension education and the “Hypertension Education Booklet” for a duration of four weeks (n = 4). ResultsThe post-test measurements of patients in the experimental group (after 4 weeks of education) revealed an increase in the mean MARS scores (6.50 ± 0.86) and a significant decrease in the total and subscale mean scores of PAIS-SR (24.12 ± 7.08) (p < 0.05). No changes were observed in the control group patients. ConclusionThe results of the study revealed that the education based on the Roy's Adaptation Model increased hypertensive individuals’ medication adherence and physiological, psychological, and social adjustment to the disease. Relevance to clinical practiceThe education based on the Roy's Adaptation Model seems to be effective in increasing patients' adherence to treatment and adjustment to the disease. This model can be used in various diseases and societies, since it increases adjustment to the disease and the effectiveness of treatment.

The Effect of Death Anxiety on Psychosocial Adjustment in Individual With Chronic Obstructive Pulmonary Disease.

Objectives:This study was carried out in a descriptive manner to determine the effect of death anxiety on psychosocial adjustment in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods:The study was carried out on 150 inpatients and outpatients who were being treated at the thoracic diseases department of a state hospital during January 1– April 20, 2016. Personal information form, death anxiety scale (DAS) and psychosocial adjustment to illness scale-self report (PAIS-SR) were used for data acquisition. The data were analysed through IBM Statistical Package for the Social Sciences 22 software.Results:The DAS score average of the patients was determined as 6.96 ± 3.45, PAIS-SR total score average was determined as 67.54 ± 14.96. A positive and statistically significant relationship was determined between the death anxiety of the patients and their psychosocial adjustments (P < 0.05).Conclusion:It can be concluded as a result of the study that the death anxieties of COPD patients are at a moderate level, that their psychosocial adjustments to the disease are at a bad level and that their psychosocial adjustments to the illness and to life are disrupted with increasing death anxiety. Psychiatry nurses can contribute to increasing the psychosocial adjustment to the illness of the patient by helping the patient and his/her family in adjusting to the changes in their life styles, preventing non-beneficial adjustments, developing the coping skills of the patient and his/her family and accordingly making the necessary planning.

The relationship between psychopathology, psychosocial adjustment, social support and quality of life in multiple sclerosis

Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and social functioning of patients. In this study we aim to indicate psychiatric comorbidity, some psychosocial factors and their associations with quality of life in patients with MS. Methods: A total of 227 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Multiple Sclerosis Quality of Life-54 (MSQOL-54), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR) and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Among 227 patients with MS, 67.8% (n = 154) had psychiatric diagnosis; 24.2% (n = 55) had depression,19.8% (n = 45) had adjustment disorder, 14.9% (n = 34) had anxiety disorder, 7.1% (n=16) had dysthymic disorder and 1.8% (n = 4) had bipolar disorder. Patients with a psychiatric diagnosis had lower scores in role limitations due to emotional problems, emotional well-being, health perceptions, social function, cognitive function, health distress and mental health composite of MSQOL-54. PAIS-SR and MSPSS scores were significantly lower in MS patients with a psychiatric diagnosis. PAIS-SR scores were negatively correlated with role limitations-emotional, emotional well-being, social function, sexual function, satisfaction with sexual function, physical health composite and mental health composite scores of MSQOL-54. MSPSS total score was positively correlated with emotional well-being score of MSQOL-54. Conclusions: In MS patients, there is a high prevalence of psychopathology and it is associated with quality of life, perceived social support and psychosocial adjustment of the patients. Quality of life is reduced especially in emotional and mental aspects in patients with a psychiatric diagnosis. Diagnosis and treatment of psychopathology in MS patients seems crucial to decrease disease burden.

Health Related Quality of Life Among Patients With Multiple Sclerosis: The Role of Psychosocial Adjustment to Illness

BackgroundMultiple Sclerosis (MS) is associated with poor quality of life (QOL). Individuals suffering from MS must make multiple adjustments as their condition changes. To date, little is known about the role of psychosocial adjustment in improving QOL of patients with MS. PurposeThe purpose of this study is to identify the relationship between psychosocial adjustment and HRQOL controlling for demographic variables among patients with MS. MethodsThis study used a descriptive-correlational design. A sample of 160 patients from two hospitals participated in the study. Self-reported data were collected using the demographic survey, Multiple Sclerosis Quality of Life (MSQoL-54) tool and Psychosocial Adjustment to Illness Scale–Self Report (PAIS-SR). ResultsParticipants reported poor QOL and difficulty with psychosocial adjustment. The QOL and psychosocial adjustment were correlated with various demographic variables. After controlling for demographic variables, psychosocial adjustment explained a large variance in the mental health composite of QOL (r square change = 44%) and the physical health composite of QOL = (r square change = 38%). ConclusionPsychosocial care could play a vital role in improving quality of life among MS patients.

Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor.

To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were 1.57±0.51, 0.37±0.64, 3.62±0.67, and 4.00±0.45, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

Psychosocial Adjustment to Illness Scale: Factor structure, reliability, and validity assessment in a sample of Greek breast cancer patients

ABSTRACTThe study and measurement of psychosocial adjustment is important for evaluating patients’ well-being, and assessing the illness’s course, treatment’s success, and patients’ recovery. In this study, internal consistency reliability and construct validity of the Greek version of the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR) were examined. Demographic and psychosocial data were collected from a sample of 243 women with breast cancer, recruited from September 2011 to December 2012. With some exceptions in specific items, the original conceptually-derived PAIS-SR subscales emerged in a seven-factor solution. Social Environment, Job and Household Duties, and Psychological Distress accounted for more of the total variance than other subscales. PAIS-SR showed good internal consistency reliability, with Cronbach’s alpha coefficients >0.62. Correlations of PAIS-SR domains with measures of quality of life and posttraumatic stress symptoms supported the convergent validity of the PAIS-SR and its significance for cancer research. The Greek version of the PAIS-SR has acceptable internal consistency reliability and construct validity, as well as satisfactory convergent validity. Results provide some suggestions for the development of programs to evaluate adjustment status and implement psychosocial interventions among breast cancer survivors.

Psychometric properties of the Chinese version of Sexual Function after Gynecologic Illness Scale (SFAGIS)

This study aims to develop the Chinese version of the Sexual Function after Gynecologic Illness Scale (SFAGIS) and to establish its psychometric properties in Hong Kong Chinese patients with gynecological cancer. A Chinese version of SFAGIS was developed using the Brislin model of translation and guidelines for cross-cultural adaptation of scales. The content validity and semantic equivalence were assessed by an expert panel. The translated version of SFAGIS was administered to 150 Hong Kong Chinese women with gynecological cancer to test the scale's psychometric properties and to assess its feasibility. The convergent validity of the Chinese scale was tested by correlating it with the Chinese version of the sex relations subscale of the Psychosocial Adjustment to Illness Scale Self-Report (PAIS-SR). The average completion time for the Chinese SFAGIS was 16.2 ± 6.6 min. The internal consistency of the Chinese SFAGIS was 0.93. Test-retest reliability was also high with an interclass correlation coefficient 0.76. A Pearson product-moment correlation found strong correlations among the Chinese SFAGIS and the Chinese version of the sex relations subscale of the PAIS-SR, indicating that both scales measure the same as or has a similar construct. The Chinese version of SFAGIS is a reliable and valid instrument which can be used in clinical practice and research for assessing sexual function problems in Chinese patients with gynecological cancer and to identify those in need of attention.

The Impact of Chemotherapy-Induced Cognitive Impairment on the Psychosocial Adjustment of Patients With Nonmetastatic Colorectal Cancer

Colorectal cancer is the third most commonly diagnosed cancer in Canada. Chemotherapy often is used as treatment for colorectal cancer, and studies have documented cognitive changes in patients after chemotherapy treatment. What remains unclear is the impact of such changes on a person's roles and relationships, herein referred to as psychosocial adjustment. The purpose of this research was to explore group differences in psychosocial adjustment and chemotherapy-induced cognitive impairment in patients with colorectal cancer. Participants were assessed cross-sectionally, at various time points along their treatment trajectory, using the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). A statistically nonsignificant negative association was indicated between PAIS-SR and CANTAB results, indicating that they would have no meaning in a clinical context. No differences between groups were observed in terms of cognitive ability; however, patients who completed chemotherapy appeared to be at a higher risk for psychosocial maladjustment. This study suggests that cognitive changes do not influence patients' relationships and functional roles, as indicated from the PAIS-SR.

(Not) talking about sex: a systematic comparison of sexual impairment in women with systemic sclerosis and other chronic disease samples

Sexual impairment in women with SSc has received little attention. The objective of this study was to compare levels of sexual impairment in women with SSc with samples of women with medical illnesses for which sexual impairment has been researched more extensively. SSc patients completed the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR). A systematic review was conducted to select comparison samples. Sexual Relationships subscale scores from SSc patients were compared with scores from comparison samples (breast or gynaecological cancer and HIV) using t-tests and Hedges's g to calculate effect sizes. Samples from 138 female SSc patients were analysed (28.3% diffuse; mean age 52.1 +/- 12.3 years; mean time since diagnosis 9.0 +/- 8.3 years). Women with dcSSc (6.1 +/- 4.2) reported significantly greater sexual impairment (P < 0.05) than those with lcSSc (4.4 +/- 4.2), three breast cancer samples (1.8 +/- 0.1, 3.4 +/- 3.9, 1.6 +/- 0.6) and two samples of HIV-positive female patients (4.4 +/- 3.8, 4.5 +/- 3.9). Scores in dcSSc were similar to one sample of HIV-positive women (5.8 +/- 4.1) and gynaecological cancer patients (7.3 +/- 4.3). Scores in lcSSc were significantly higher than two breast cancer samples, similar to one breast cancer sample and two HIV-positive samples, and significantly lower (P < 0.05) than in one HIV sample and gynaecological cancer. Women with SSc, particularly those with dcSSc, have high levels of sexual impairment compared with women with other chronic diseases, where sexual function has received greater attention. Further research is needed on sexual function among women with SSc.

The Influence of Life Stage on Psychosocial Adjustment in Colorectal Cancer Patients

The influence of life stage on psychosocial adjustment and on factors related to this adjustment were examined in post-operative colorectal cancer patients without stoma. PAIS-SR (Psychosocial Adjustment to Illness Scale-Self-Report) was used to assess psychosocial adjustment, and patients were divided into two groups; a senior group (age > 65 years, n =34) and a non-senior group (age < 65 years, n =59) based on cultural features in Japan. Results were compared between two groups for each of the following PAIS domains: “vocational environment,” “domestic environment,” “sexual relationship,” “extended family environment,” “social environment,” and “psychological distress.” Psychosocial adjustment was found to differ by life stage only for “psychological distress” (non-senior vs. senior: 48.6 ± 9.4 vs. 44.7 ± 7.7, p < .05). However, analysis of background factors related to psychosocial adjustment revealed distinct patterns in each life stage. This study suggests that life stage should be considered when attempts are made to improve the psychosocial adjustment among cancer patients.

The cost of poor adjustment to chronic illness: lessons from three studies

This paper summarizes information about expenditures for people with chronic illness as a function of their psychosocial adjustment to illness. Three studies are discussed: two prospective baseline surveys and one historic cohort analytic study. Each was conducted between 1988 and 1993 in Southern Ontario, Canada in tertiary centres which were treating patients recently referred to a specialty medical clinic for one of 13 types of chronic physical illnesses. All three studies used the same measures: The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) (Derogatis & Lopez 1983) and the Health and Social Service Utilization Inventory (Browne et al. 1990) which translates utilization into a measure of dollar expenditure for utilization. Poor adjustment to chronic illness exceeded the importance of disease severity and levels of disability in explaining a disproportionate level of expenditures for a subgroup of people (34–55%) attending specialty medical clinics. The cost of providing more comprehensive health and social care for this group could be less than the amount spent in maintaining their poorly adjusted state by providing only medical care.

Predictors of psychosocial adjustment in people with physical disease

The purpose of this paper was to examine the demographic, medical and psychosocial variables that result in the deterioration of psychosocial adjustment in patients with physical disease, the meaning their illness has for them and their coping style. The study was carried out in inpatient clinics of the Istanbul Faculty of Medicine (n = 198). The following evaluation instruments were used: a semi-structured questionnaire, the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), the Meaning of Illness Questionnaire (MIQ), the Hospital Anxiety-Depression Scale, the Multivariate Perceived Social Support Questionnaire and the Ways of Coping Inventory (WCI). Variables to be related with psychosocial adjustment were analysed by using Forward Logistic Regression. The mean age of patients was 36.9 (SD 12.9) (18-65), 55% of which were women, the average PAIS-SR score was 1.02 (SD 0.41) (0.7-2.26); 47% of the patients had poor adjustment scores. Univariate analysis showed that psychosocial adjustment was affected by having children (p = 0.02), anxiety, depression, locus of control, perceived social support (p < 0.001), information level about their illness and its treatment (p = 0.01), the subscales of WCI [escape-avoidance (p < 0.001), distancing (p = 0.002), planned problem solving (p < 0.001), positive re-appraisal (p = 0.02)]. The psychosocial adjustment of patients with respiratory or infectious illnesses or bone-muscle-skeletal disorders was even less (p = 0.03). All 33 items of the MIQ were found to have a significant impact on psychosocial adjustment (p < 0.001). According to the regression analysis, the best predictors of psychosocial adjustment were: depression (p < 0.001) and the meaning of illness for patient (p < 0.01). Having a physical illness is an important stress factor. In providing assistance, a number of factors should be taken into consideration, including how the patient perceives his illness, the impact the illness has on the patient's life, and a determination of the degree of depression being experienced by the patient. The study indicated some predictors in the assessment of psychosocial adjustment and care of patients with physical illness. In daily clinical practice, among the patients with physical illness, those with a negative perception of their illness and those who define depression should be given special attention for psychosocial support.

Psychosocial adaptation in surgically treated patients for laryngeal cancer

The objective of the study was to assess the psychosocial adaptation in 62 patients surgically treated for head and neck cancer. Forty-one patients were grouped as having had radical surgery (total laringectomy), and twenty-one as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale Self-Report (PAIS-SR) was used for the evaluation. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. Information collected in this way may facilitate improved rehabilitation and, thus, better quality of life.

Psychosocial adjustment in patients surgically treated for laryngeal cancer.

To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. Study design and setting Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. Information collected in this way may facilitate improved rehabilitation and thus better quality of life.

Psychosocial adjustment in patients surgically treated for laryngeal cancer

To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. Study design and setting Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. Information collected in this way may facilitate improved rehabilitation and thus better quality of life.

The impact of narcolepsy on psychological health and role behaviours: negative effects and comparisons with other illness groups

Objectives: The study sought to (i) assess psychosocial adjustment, disruption due to symptoms, and medication problems in narcolepsy, (ii) determine how these variables changed with gender, age and medication status, and (iii) compare narcolepsy adjustment with three other illness groups. Background: Psychosocial adjustment to an illness can be conceptualized in terms of people's ability to function in their life roles and assessed using the Psychosocial Adjustment to Illness Scale – Self Report (PAIS-SR) questionnaire. Methods: Participants ( n=129) were recruited via a support group using posted questionnaires. The PAIS-SR was supplemented with additional questionnaire material. Results: Males were more vulnerable than females in terms of adjustment (notably health care orientation and sexual relationships) and younger narcoleptics may have particular vocational problems. Unmedicated narcoleptics were least inclined to participate in social/leisure activities. Reported disruption due to symptoms was strongly associated with both psychological distress and overall psychosocial adjustment and was most notable in those taking both stimulants and tricyclic antidepressants. Narcoleptics reported more adjustment problems in comparison to three other illness groups (cardiac, mixed cancer and diabetes). A table of normative PAIS-SR values for narcolepsy was developed. Conclusions: Poor adjustment in terms of health care orientation and psychological distress are of particular concern. Health care that can reduce the disruption due to symptoms is especially important for adjustment.

Intensive outpatient adjuvant therapy for breast cancer: results of dose escalation and quality of life.

A dose-escalation study was conducted to determine the maximum-tolerated dose (MTD) and dose-limiting toxicities (DLTs) of cyclophosphamide (CY) in combination with granulocyte colony-stimulating factor (G-CSF0 and doxorubicin (DOX) given every 2 weeks for eight cycles as outpatient adjuvant therapy for node-positive breast cancer. A pilot study to assess quality of life (QOL) was performed. From March 1991 to April 1993, 19 patients were entered. Patients received escalating doses of CY intravenously (i.v.) (1,000 mg/m2, 1,500 mg/m2, 2,000 mg/m2, or 2,500 mg/m2) with DOX 40 mg/m2, G-CSF 10 micrograms/kg/d on days 2 to 12, and mesna, every 2 weeks for eight cycles. QOL was measured by the Profile of Mood States (POMS), the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a 27-item QOL scale. The CY dose of 2,500 mg/m2 every 2 weeks elicited toxicities that required dose reductions secondary to a combination of thrombocytopenia, hematuria, and anemia that required transfusion. The dose of 2,000 mg/m2 resulted in an acceptable toxicity profile. Ninety-two percent of cycles at the 2,000-mg/m2 dose were delivered on schedule and 77% without hospitalization. QOL assessments indicated high levels of distress measured by POMS in 47%, poor overall quality of life in 40%, and significant problems with physical symptoms in less than 27% of all patients for any given cycle. A dose of CY at 2,000 mg/m2 can be administered every 2 weeks with DOX and G-CSF for eight cycles in the outpatient setting with manageable toxicity. The majority of women described levels of physical symptoms and emotional distress as tolerable during treatment.

Psychologic characteristics of polio survivors: a preliminary report.

Ninety-three men and women with histories of polio were administered the Symptom Check List-90 Revised (SCL-90R), Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a questionnaire about their polio histories. The SCL-90R and PAIS-SR are measures of emotional and psychosocial functioning. Two samples were used: a clinic sample (n = 71) and a postpolio support group sample (n = 22). Initial results for both on the SCL-90R and PAIS-SR indicated elevated scores on a number of subscales. SCL-90R subscale elevated scores for men included those for somatization, depression, anxiety, hostility, and phobia, whereas for women there were elevations on measures of somatization, depression, anxiety, and psychoticism. Elevations were found in the following subscales on the PAIS-SR (pooling men and women): health care orientation, social environment, and extended family relationships. Men scored slightly, but not significantly, higher than women in the SCL-90R except for the hostility subscale, in which the difference was significant (p less than 0.05). Symptom profiles indicated psychologic distress. Comparisons with variables associated with polio and its late effects (such as severity of initial polio, use of an iron lung during initial illness, number of involved limbs, etc) were not statistically significant.