The development of the Profile of Adaptation to Life within a medically ill population: PAL-M.

The social work department at a biomedical research hospital was challenged to improve efficiency and accountability regarding psychosocial care of its patients. This article presents the process of selecting and revising the Profile of Adaptation to Life (PAL) into a screening instrument that identifies the hospital's most vulnerable patients who need to have a full psychosocial assessment completed by the social worker. The PAL was selected because it includes identifiable risk factors across the psychosocial spectrum, is cost-effective, and easy to administer and score. Factor analysis and reliability analysis resulted in a promising instrument, the Profile for Adaptation to Life-Medical (PAL-M), for use in rapid, psychosocial risk screening with medically ill patients. Based on the analysis, the authors updated the PAL's original language, clarified introductory wording of some questions, and expanded demographic information.