Comparison of the Psychosocial Adjustment to Illness Scale-Self Report and clinical judgment in patients with chronic lung disease

J Cardiopulm Rehabil. 1998 Jan-Feb;18(1):32-6. doi: 10.1097/00008483-199801000-00004.


Background: The study assessed the value of the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) in determining the psychosocial impact of impairment and disability in patients with chronic irreversible airflow limitation.

Methods: Fifty-six consecutive patients admitted to respiratory rehabilitation were studied. Psychosocial adjustment was measured with the PAIS-SR and was judged separately by two health-care workers on the rehabilitation team. Agreement between the PAIS-SR and the health-care workers was determined using the Kappa statistic.

Results: Four subjects did not complete the questionnaire. The data from 52 subjects were analyzed. The mean forced expired volume in one second (FEV1) was 1.2 +/- 0.4 L. The mean age was 66.4 +/- 9.0 years. There was good agreement between the individual assessment of each health-care worker (P < 0.001). There was good agreement between the score on the PAIS-SR and the clinical assessment by each of the health-care workers (P < 0.001). However, there were 10 subjects who identified severe adjustment difficulties that were not recognized by the health-care professionals.

Conclusion: Although there was agreement between the PAIS-SR and clinical judgment in assessing the psychosocial impact impairment and disability in chronic airflow limitation, the PAIS-SR may identify individuals with adjustment difficulties not recognized by members of the health-care team. The results support the routine use of objective measures to assess the psychosocial impact of chronic airflow limitation.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living*
  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung Diseases, Obstructive / psychology*
  • Lung Diseases, Obstructive / rehabilitation
  • Male
  • Middle Aged
  • Observer Variation
  • Prospective Studies
  • Referral and Consultation
  • Reproducibility of Results
  • Sickness Impact Profile*
  • Social Work
  • Surveys and Questionnaires / standards*