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Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A significant relationship exists between perceived stress and the exacerbation and perpetuation of chronic pruritic dermatoses. Despite this, there is a notable absence of validated tools to specifically measure pruritus-associated stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and pilot the Pruritus-Associated Stress Scale (PASS), a patient-reported outcome measure (PROM) for assessing pruritus-associated stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients with chronic prurigo (CPG), atopic dermatitis (AD), and chronic pruritus on non-lesional skin (CPNL) were recruited at a German university center. They were interviewed on pruritus-associated stress, and perceived stress using the PSS-10 and PSQ-30 questionnaires, to compile the first PASS version in accordance with the guidelines for PROM development. Subsequently, a second patient cohort was interviewed to refine the items of the PASS instrument based on impact analysis, interitem and item-total correlation, and internal consistency reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 55 patients (15 with AD, 20 with CPG, and 20 with CPNL; 61.8% female; mean age 61.0 \u00b1 15.4 years), who participated in the item selection phase, 94.5% reported pruritus-associated stress in the previous 2 weeks. The preliminary PASS demonstrated excellent internal consistency (Cronbach\u2019s alpha = 0.91). The 12 items that showed strong impact scores addressed nervousness, therapeutic strategies for managing pruritus-associated stress, fatigue, and urges to scratch more frequently or intensely due to pruritus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study yielded a preliminary PASS, identified poorly performing items, and collected information for further refinement. As a next step, retaining the full item pool, an exploratory factor analysis will be conducted in a larger sample.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1683259","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T06:45:14Z","timestamp":1765953914000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of the pruritus-associated stress scale: a cross-sectional pilot 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