'New to me' - changing patient understanding of psoriasis and identifying mechanisms of change: The Pso Well(®) patient materials mixed methods feasibility study

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Abstract

BACKGROUND: Psoriasis is an inflammatory, long-term condition (LTC) involving co-morbidities, unhealthy lifestyle and significant life impact. Patients' understanding of psoriasis is limited and support lacking. The Common-Sense Self-Regulatory Model emphasises the role of illness/treatment beliefs on coping/self-management. New 'Pso Well(®) ' patient materials informed by the model addressed: psoriasis as a LTC; medications management; and lifestyle behaviours.

OBJECTIVES: To investigate whether Pso Well(®) materials: 1) broaden understanding of psoriasis without increasing anxiety; 2) are acceptable and; 3) comprise features that appear to effect change.

METHODS: The Revised Illness Perceptions Questionnaire (IPQ-R modified) and the Hospital Anxiety and Depression Scale (HADS) were administered in patients pre-/post-intervention. Numerical Rating Scales (NRSs) assessed perceptions of change in understanding/anxiety. Qualitative interviews explored acceptability and perceived 'active ingredients'.

RESULTS: Fifty five patients completed pre-/post-intervention questionnaires (56% female; median age 59 years). Post-intervention, a large effect size was indicated in two IPQ-R domains: illness coherence (t [55] = -3.48, p=.001 [two-tailed], eta(2) =0.19) and personal control (t [55] = -2.98, p=.004 [two-tailed], eta(2) =0.14); and a medium effect in one: treatment control (t [55] = -2.08, p=.042 [two-tailed], eta(2) =0.08). HADS scores did not change. For NRSs, 80% of participants reported increased understanding of psoriasis and no increased anxiety. Interviews with 19 patients indicated materials were acceptable/usable. Factors reported to broaden understanding/promote engagement with self-management included: linking of related disease aspects; personally relevant content; and high quality design.

CONCLUSIONS: High quality, theory-based psoriasis materials are acceptable to patients and can improve understanding/sense of control without increasing anxiety. This article is protected by copyright. All rights reserved.

Bibliographical metadata

Original languageEnglish
JournalThe British journal of dermatology
Early online date12 Apr 2017
DOIs
Publication statusPublished - 2017

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