Psoriasis patients harbor feelings of guilt and shame, feelings of incompetence, disrespect, and fear of expulsion from a job (Ghorbanibirgani, Khoshknab, Zarea, & Abedi, 2015). Along with depression, they also suffer alexithymia leading to difficulty in describing or recognizing emotions. Psoriasis has a severe negative impact on quality of life of patients. Those who suffer from skin diseases not only have to cope with the disease, but also experience the negative reaction of others because of the stigma associated with the disease (All Party Parliamentary Group on Skin (APPGS), 2013).
Social support is considered to have a buffering effect on the negative aspects of stress in various patient groups (Janowski, Steuden, Pietrzak, Krasowska, Kaczmarek, Gradus, & Chodorowska, 2012). Patients gain relief, reassurance, practical information, guidance, and superior coping skills through support groups. Disease-based support groups assemble people who share the same disease-related challenges. They give and receive emotional support and exchange disease-related information. People with chronic medical conditions join support groups to cope with the emotional and practical challenges of the disease. Participants in support groups reported having many benefits, such as obtaining emotional support and receiving information about the disease and treatment (Delisle, Gumuchian, Kloda, Boruff, El-Baalbaki, et al. 2016).
Mutual support and shared experiences of persons with similar conditions that are characteristic of a support group can benefit those suffering from low levels of self-esteem, confidence, and morale. Janowski et al. 2012) reported that higher social support led to higher quality of life, lower depression levels, and higher acceptance of life with the disease. A support group provides patients the validation that they are not alone in their struggle with psoriasis. Patient education involves helping patients become better informed about their condition, medical procedures, and choices they have regarding treatment. A single educational intervention for patients could increase their knowledge about psoriasis, providing opportunities to share their feelings, helping them cope with psoriasis in daily life and developing a better attitude towards providers and treatment. The evidence supports the efficacy of educational sessions and support groups for this group of patients. It is found that patient education can improve knowledge, quality of life and reduce the apparent severity of psoriasis. Hence, a psoriasis support group is beneficial because patients meet others with whom they can relate.
The purpose of the DNP scholarly project was to implement an educational program along with a psoriasis support group. The goal of this project was to increase patients’ knowledge about psoriasis, provide opportunities to share their feelings, improve self-esteem and quality of life, and develop a better attitude towards healthcare providers and treatment. The theoretical framework that guided this study was Wilson and Cleary’s (1995) conceptual model of health-related quality of life (HRQOL). This was an interprofessional DNP project conducted at a College on Long Island, NY, in collaboration with the Department of Social work. The design for this project was one-group quasi-experimental pretest-posttest design. In this, a single group of psoriasis patients was pretested on their knowledge, self-esteem, psoriasis-related stress, and quality of life using specific tools. A purposeful sample of seven patients, an optimal size for a support group, participated in this project. The support group sessions lasted for seven weeks. It also included five weeks of education on psoriasis and its treatment, symptom management, best practices, and ways to cope with the disease. A post-test was conducted at the end of the support group program using the same tools. Psoriasis Quiz, Rosenberg Self-Esteem Scale (RSES), Psoriasis Life Stress Inventory (PLSI), and Dermatology Life Quality Index (DLQI) were the tools used in this project. Results indicated that there was an increase in patients’ knowledge and self-esteem, decrease in psoriasis-related stress, and improved quality of life. The paired t-test comparing the mean of the pre and post-program scores of self-esteem, stress related to psoriasis and quality of life were statistically significant at p < 0.05. Participants expressed the need to continue the sessions at the end of the program. The results support the literature, and further study with more extended duration is recommended.
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